International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Heterotopic pregnancy: a case report

2025-10-30T06:27:27+0530

Heterotopic pregnancy is a potentially life-threatening condition if left undiagnosed. Early pregnancy ultrasound is a key diagnostic tool in all symptomatic cases or where there are risk factors and clinical suspicion. Multi-professional discussion is essential in decision making. As this patient miscarried the intrauterine pregnancy, and the ectopic pregnancy appeared to be resolving spontaneously, no further laparoscopic intervention was required. Only monitoring β-hCG levels till it reached the non-pregnant levels helped to confirm complete resolution.

Sclerosing stromal tumor of the ovary: a rare case report

2025-10-30T06:28:52+0530

Sclerosing stromal tumors (SST) are rare benign tumors of the ovary, accounting for less than 5% of all sex cord-stromal neoplasms. We report the case of a 33-year-old woman who presented with pelvic pain and was found to have a 78×55 mm heterogeneous semisolid mass in the left adnexa on ultrasonography. Pelvic magnetic resonance imaging revealed a well-circumscribed adnexal lesion with both solid and cystic components, raising suspicion for a neoplastic process. The patient underwent laparoscopic left salpingo-oophorectomy. Final histopathological examination confirmed a diagnosis of SST, with an intact capsule and immunohistochemical staining positive for CD31 and CD34, and negative for cytokeratin AE1/AE3, inhibin A, and desmin. The Ki-67 proliferation index was 6%, and peritoneal cytology was benign. This case emphasizes the importance of including this rare tumor in the differential diagnosis of adnexal masses and highlights the value of minimally invasive surgery in their management.

Homozygous SMN1 gene deletion as a cause of intrauterine and neonatal mortality

2025-10-30T06:28:52+0530

Deoxyribonucleic acid is not only responsible for normal functioning and metabolism of body by the formation of essential proteins which are responsible for individuals growth and development but it is also responsible for transferring traits & genetic disorders from parents to their offspring, either these genetic traits make them carriers or major diseased individual, these conditions may arise because of any false nucleotide base insertion, or nucleotide deletion or any gene replacement due to radiations or mutations. SMA (survival motor atrophy) is a condition that arises because of less production or unavailability of the SMN protein, which is synthesized by the SMN-1 gene. A case of 29 years old married woman (cousin marriage- Consanguinity) has been discussed, she lost her 4 babies after birth (neonatal deaths) in between the duration of 2 to 8 months, with one intrauterine miscarriage (intra-uterine death), after CVS it was found that SMN-1 was absent in the genetic makeup of her all babies, and they were not able to survive because of muscular atrophy in pulmonary muscles causing pulmonary distress and reduced body movements with edematous condition and other body organ failures including kidney and liver. It was concluded that SMN-1 gene absence is not only responsible for causing intrauterine, neonatal deaths but also causes sudden deaths in adult age suddenly by causing paralysis. Gene replacement therapies with other oligonucleotides and splicing modifiers have been introduced with the advancement of biotechnology for the treatment of SMA disease.

Benign Brenner’s tumor of ovary: a case report with review of literature

2025-10-30T06:28:48+0530

Brenner’s tumor of the ovary is a rare neoplasia with an incidence of 02-03% of all ovarian tumors. Its origin is controversial; the new hypothesis describes it as transitional cell metaplasia of Walthard cell nests embedded in the ovary. The world health organization has classified it into benign, borderline, and malignant varieties, with incidences of 95%, <5%, and <2%, respectively. Benign Brenner’s tumor (BBT) is usually <2 cm in size, unilateral, solid, grayish white, well-circumscribed, rubbery to firm nodule, arising from ovarian cortex and resembling fibroma or thecoma of ovary. The average age of patients is 50 years. Diagnosis of the pathology is challenging as it does not have a specific clinical presentation or investigatory findings, and is usually diagnosed incidentally on histological examination of the ovary resected with other genital organs. Microscopy of the tumor shows a fibro-epithelial solid mass consisting of transitional epithelial cell nests surrounded by dense fibrous tissue. No further treatment is required in benign cases, whereas chemotherapy with or without radiotherapy and follow-up is needed in borderline and malignant cases. A case of unilateral BBT of the ovary in a 42-year-old parous lady was diagnosed in this institution, who had undergone total abdominal hysterectomy with bilateral salpingo-oophorectomy for fibroid uterus with abnormal uterine bleeding (AUB) and severe anemia. The presentation aims to report this rare pathology of Brenner’s tumor without a specific clinical presentation, diagnosed incidentally on histopathological examination (HPE), and to add to the statistics.

Acute pancreatitis in the third trimester of pregnancy: a rare case report and management challenges

2025-10-30T06:30:26+0530

Acute 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.

Coexistence of acute fatty liver of pregnancy, gestational diabetes insipidus, and preeclampsia leading to severe hypernatremia and perinatal mortality: a case report

2025-10-30T06:27:26+0530

Acute fatty liver of pregnancy (AFLP) and gestational diabetes insipidus (GDI) are rare but life-threatening obstetric complications. AFLP is linked to hepatic dysfunction, which can impair the breakdown of placental vasopressinase, leading to GDI and eventually hypernatremia. The coexistence of AFLP with GDI can be further worsened by placental dysfunction associated with preeclampsia, due to the disruption of the placental barrier that allows fetal vasopressin to enter the maternal circulation. This rare confluence of AFLP, GDI, and preeclampsia is scarcely reported and presents significant diagnostic and management challenges. We report a 25-year-old G2P1 woman, at 36 weeks of pregnancy, presenting with fever, jaundice, altered mentation, and hypertension. Laboratory tests showed hypernatremia (195 mEq/l), low urine osmolality, and abnormal kidney and liver function tests. Swansea criteria confirmed AFLP. Sodium was gradually corrected at a rate of 6-8 mEq/l per day, and vaginal delivery was planned. A live baby weighing 2.08 kg was delivered but died from respiratory failure on day two. Maternal recovery was complete by day 11 postpartum. This case highlights the interaction between AFLP, preeclampsia, and GDI. It emphasizes the importance of careful sodium correction and increased suspicion of vasopressinase dysfunction in cases of unexplained hypernatremia.

Broad ligament leiomyoma with cystic change mimicking as ovarian tumor

2025-10-30T06:30:23+0530

Uterine leiomyomas are common benign gynaecological tumours, occurring in 20-40% of cases in India. Broad ligament fibroids, though rare (less than 1%), are the most frequent extrauterine site and can be mistaken for ovarian carcinoma due to their unusual location. This report presents a nearly asymptomatic 50-year-old woman with irregular menstrual cycles who was found to have a non-tender, mobile cystic mass equivalent to an 18-week gravid uterus. Ultrasound detected a 540 CC complex solid-cystic right adnexal lesion with an un-visualized ovary; CECT showed a 780 CC solid-cystic right ovarian mass, and MRI revealed a suspicious 570 CC solid-cystic lesion, raising concerns for malignancy. IVP was omitted as ureters were normal. Laparotomy identified a sizable cystic mass located on the right side within the broad ligament, which exhibited minimal resemblance to leiomyoma and resulted in mild anatomical distortion. Both the uterus and ovaries appeared unremarkable. Histopathological analysis confirmed the lesion as a broad ligament fibroid exhibiting extensive cystic degeneration. Due to this atypical presentation, immunohistochemical studies were recommended to exclude malignancy. Broad ligament leiomyomas, particularly those with solid and cystic components, may mimic ovarian malignancies during clinical and radiological assessment, complicating differential diagnosis due to their atypical presentation. Histopathology plays a crucial role in establishing a definitive diagnosis. This case is presented due to its infrequency and the diagnostic uncertainty it created for both clinicians and the patient.

A case report on ovarian dermoid cyst

2025-10-30T06:28:58+0530

Ovarian dermoid cyst, also known as a mature cystic teratoma, is a benign embryonal tumor. Dermoid cysts account for approximately 10-25% of all ovarian tumors and comprise about 60% of all benign ovarian neoplasms. They are common in adolescent and young age and carry minimal risk of malignant transformation. A case of 14 year old adolescent girl presented to OBG outpatient department at Navodaya medical college, Raichur with compliant of abdominal pain since 1 month. Ultrasonography features suggestive of right dermoid cyst, further evaluated with tumour markers. Managed with laparotomy and proceed. Understanding the epidemiology, clinical features and imaging characteristics of dermoid cysts is essential for accurate diagnosis, to prevent complications and treatment planning.

Spontaneous hematuria after caesarean section: a case report and review of literature

2025-10-30T06:28:57+0530

Hematuria occurring postoperatively is typically associated with urinary tract infection, renal pathology, or surgical trauma. However, delayed-onset hematuria following caesarean section (CS) is uncommon and may point toward less frequently encountered etiologies directly or indirectly related to the surgical procedure. A patient presented with spontaneous gross hematuria on the 29^th day after an uncomplicated CS. She had no fever, flank pain, or urinary symptoms. Preliminary investigations ruled out infection and renal pathology. Advanced imaging and cystoscopic evaluation were conducted to explore structural or vascular causes. Potential etiologies identified included retroperitoneal hematoma, vesicouterine fistula, and occult bladder injury. Diagnostic evaluation was challenged by the delayed timeline and non-specific presentation. Imaging techniques such as CT/MRI, cystoscopy, and dye tests proved critical in delineating the source. Spontaneous hematuria in the late postoperative period following CS is rare but warrants systematic evaluation to identify overlooked surgical or anatomical causes. Early diagnosis and targeted intervention are crucial to prevent long-term morbidity.

Management of cervical atresia and vaginal aplasia leading to hematometra and endometriosis in a young patient: a case report

2025-10-30T06:28:50+0530

Cervicovaginal atresia is a rare congenital anomaly of the female reproductive system where there is a complete absence or severe underdevelopment of the cervix and /or vagina usually presenting in adolescence with severe abdominal pain and primary amenorrhoea which can further lead to endometriosis and pelvic mass. Hereby, we are reporting such a rare case of cervicovaginal atresia in 24 years female who was managed with hysterectomy. Surgery is not strictly required during menstruation, but if there is hematometra, the surgery should be performed as soon as possible to relieve the obstruction. This case reporting aims to offer insights and recommendations for future research on cervicovaginal atresia, ultimately striving to enhance the quality of life for affected individuals.

Septic shock with multiple organ dysfunction syndrome, disseminated intravascular coagulation and mucormycosis following unsafe abortion: a case of acute infectious purpura fulminans

2025-10-30T06:28:49+0530

A woman in her early thirties presented to the emergency department in the 2^nd week of her illness. She had a history of self-MTP kit intake at 12 weeks gestation followed by dilatation and curettage by the local practitioner for incomplete abortion. She started having a fever and developed blisters all over her body. On presentation, thorough history and examination confirmed sepsis and septic shock. Management continued with the sepsis campaign recommendation 2021 in the critical care unit. In the sixth week of her stay, she developed methicillin-resistant Staphylococcus aureus (MRSA) and mucormycosis further complicating her management. The patient succumbed to her illness after 6 weeks of aggressive treatment including daily wound debridement, amputation, and colostomy. This case emphasizes the importance of contraception use and the prevention of unwanted pregnancy. Further to reduce maternal morbidity and mortality, safe abortion practices should be opted for.

Cutting through the complexity: caesarean section with simultaneous salpingo-oophorectomy for mature dermoid cyst at term: a case report

2025-10-30T06:28:45+0530

Adnexal masses are identified in approximately 2 to 20 out of every 1,000 pregnancies a rate that is about 2 to 20 times higher than in non-pregnant individuals of the same age group. The most frequently encountered types during pregnancy include dermoid cysts (32%), endometriomas (15%), functional cysts (12%), serous cystadenomas (11%), and mucinous cystadenomas (8%). Malignancy occurs in about 2% of cases. Most adnexal masses in pregnancy can be safely observed, with nearly 70% resolving spontaneously. However, surgical intervention is occasionally required due to symptoms, suspected malignancy, or the risk of ovarian torsion. Ultrasound is the preferred imaging modality, valued for its safety, diagnostic accuracy, and widespread availability. Dermoid cysts, in particular, can present diagnostic and management challenges during pregnancy. When surgery is necessary, the second trimester is generally the optimal window, as it allows time for possible spontaneous resolution and offers better visualization conditions due to uterine size and anatomical positioning. Nevertheless, surgery should not be delayed solely based on gestational age when there is a clear clinical indication. When performed in a setting with appropriate obstetric, anaesthetic, and neonatal support, surgical management of adnexal masses during pregnancy is typically associated with favourable outcomes for both the patient and the fetus.

Primary amenorrhea due to Asherman syndrome with dermoid cyst excision

2025-10-30T06:27:39+0530

Primary amenorrhea is less common than secondary amenorrhea. It can be caused by various anatomical, genetic, or hormonal factors during the development of the reproductive organs. Congenital absence of the endometrium or sclerotic endometrium is a very rare cause of primary amenorrhea. We describe a case of sclerotic or non-functional endometrium in the context of normal female karyotype 46 XX and recurrent dermoid cyst.

Nephritic syndrome complicating placental site trophoblastic tumour: a case report and review of the literature

2025-10-30T06:27:36+0530

Placental site trophoblastic tumour (PSTT) is rarely associated with renal disorders and has been described only a few case reports so far. Authors report the case of a 27-year-old female who presented with abnormal uterine bleeding post vaginal delivery and developed nephritic syndrome, thereafter. Detailed evaluation revealed increased levels of human chorionic gonadotropin (beta subunit)-β-hCG, and imaging findings suggesting gestational trophoblastic disease. The patient underwent hysterectomy, which led to immediate remission of proteinuria, ascites and hypertension. Thus, the diagnosis was confirmed as PSTT and, following treatment, her β-hCG became normal and proteinuria gradually disappeared. This type of association of gestational trophoblastic disease with renal disorders is a rare entity. A thorough review of the literature was also performed by us, in order to explain the pathophysiology as well as the relation between these conditions so that these unusual findings can be interpreted appropriately to achieve the correct diagnosis.

Incarcerated vaginal ring pessary: a case report

2025-10-30T06:27:35+0530

We report a rare case of a 75-year-old postmenopausal woman with a long-standing ring pessary for third-degree uterovaginal prolapse, managed conservatively due to significant cardiac comorbidities. She presented acutely with perineal pain, vaginal bleeding, and urinary difficulty. Examination revealed an incarcerated pessary embedded in the anterior cervical lip, encased by a fibrous band causing bladder compression. Prompt bedside surgical release under local anesthesia led to successful removal. This case underscores the importance of strict follow-up in elderly pessary users, as even well-tolerated long-term use can result in unexpected, serious complications.

Navigating dual vulnerability: a rare case of esthesioneuroblastoma in pregnancy

2025-10-30T06:27:23+0530

Esthesioneuroblastoma (ENB) is a rare malignancy of the sinonasal tract from the olfactory neuroepithelium. Our purpose is to highlight this scarcely described but aggressive tumor presenting in a unique setting where the patient is facing dual vulnerabilities: pregnancy and EBN. We report a case of a 29-year-old female (G2P1L1), 24 weeks pregnant, with a history of progressively increasing left side nasal mass with proptosis, diplopia, nasal discharge, and bleeding from the mass. MRI showed a polypoidal mass in the left nasal cavity with intraorbital and intracranial extensions. The biopsy revealed Hyams grade 2 ENB. Management included craniofacial resection of the lesion and chemoradiation. Caesarean section was performed at 32 weeks, and the patient delivered a baby with a birth weight of 1.463 kg. Early diagnosis and timely intervention, combined with a multidisciplinary approach, for craniofacial resection and chemoradiation, can yield favourable outcomes in this challenging condition.

Lateral cervical fibroid: a case report with review of literature

2025-10-30T06:27:32+0530

Cervical fibroid constitutes 1-2% of total fibroids and is usually solitary as the cervix is deficient in myometrium. It is classified into anterior, posterior, lateral, and central depending on its location. Being estrogen dependent, it is common in the reproductive age group. Lateral cervical fibroids constitute 10.26% of total cervical fibroids as reported by one retrospective observational cohort study. Symptoms of lateral cervical fibroid are vague and depend on its site and size. Chronic pelvic pain, dyspareunia, abnormal vaginal bleeding, and pressure effect on bowel in a left-sided lesion are the usual symptoms in a lateral cervical fibroid. As it grows into the broad ligament, compression of the ipsilateral ureter with renal affection is early. The patient’s obstetric outcome is likely to be affected. Pressure on pelvic vessels may cause hemorrhoids and edema in the legs. Growth and extension of this fibroid into the broad ligament distorts pelvic anatomy. Its definitive management is surgery, which is very challenging to the surgeon, with increased risk of ureteric damage and excessive hemorrhage. We report a case of lateral cervical fibroid of 08.5×05.0 cm with constipation, and menorrhagia; foul-smelling vaginal discharge and post-coital bleeding in a 38-year-old parous lady. Total abdominal hysterectomy with bilateral salpingectomy and right oophorectomy was done under regional anesthesia. Histopathological examination confirmed the diagnosis of right lateral cervical leiomyomas, sub-mucous fibroid polyp in the uterus, and excluded malignancy. The surgery was uneventful, and the patient remained asymptomatic and healthy during postoperative follow-up. Although the incidence is low, lateral cervical fibroids are more likely to distort the pelvic anatomy around important viscera, affecting other systems early, and surgery is challenging.

Gangrenous torsion of a giant benign mucinous ovarian cystadenoma mimicking malignancy in a postmenopausal woman: a rare case report

2025-10-30T06:27:31+0530

Giant mucinous cystadenomas are rare in postmenopausal women and may mimic ovarian malignancy, particularly when complicated by torsion or ischemic necrosis. Conventional tools such as the risk of malignancy index (RMI) and ovarian-adnexal reporting and data system (O-RADS) can be misleading in these situations. Although accurate distinction is desirable, when preoperative evaluation suggests high malignant potential, comprehensive staging surgery is justified to ensure oncologic safety, even if the lesion proves benign. A 75-year-old postmenopausal woman presented with 10 days of progressive abdominal distension, dull diffuse abdominal pain, anorexia, and weight loss. Examination revealed a large abdominopelvic mass corresponding to a 32-week gravid uterus. Tumor markers were normal (CA-125:32.1 U/ml< 35; CEA: 1.85 ng/ml<3). Ultrasonography and CT demonstrated a 20 cm multiloculated complex cystic adnexal mass with irregular mural nodules but no ascites or lymphadenopathy. Risk assessment suggested high malignant potential (elevated RMI score and O-RADS 4 category). A staging laparotomy was performed. Intraoperatively, a 30 cm torsed, gangrenous mucinous cystadenoma of the left ovary with intact capsule was identified. Surgical management included total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and omentectomy. Frozen section and final histopathology confirmed a benign mucinous cystadenoma with extensive gangrenous changes. This case highlights the diagnostic dilemma of differentiating complicated benign adnexal tumors from malignancy in elderly women. It emphasizes the limitations of preoperative risk models when torsion or necrosis distorts imaging features and supports comprehensive surgical staging in high-risk profiles, even when pathology is benign, thereby ensuring oncologic safety.

Emergency twin births in ambulances: a qualitative case study from Sindh, Pakistan

2025-10-30T06:30:29+0530

Emergency childbirth, particularly twin deliveries, poses profound challenges in pre-hospital contexts, where health professionals must often act swiftly under conditions of uncertainty. In rural Pakistan, where access to healthcare facilities is limited, ambulance-based deliveries have become increasingly common. This qualitative study draws on semi-structured interviews with emergency medical technicians, emergency vehicle operators, and a skilled birth attendant in Khairpur and Naushero Feroz districts of Sindh to explore the realities of managing such emergencies. The analysis revealed that variations in training, adherence to protocols, and inter-professional coordination shaped both the process and outcomes of care. Participants described the difficulties of working within constrained environments, confronting clinical complexities, and navigating cultural and gender dynamics, all while making critical decisions under pressure. Their accounts also reflected the emotional weight of these experiences, underscoring how professional background and preparedness influence responses in moments of crisis. The study points to the urgent need for structured obstetric training, strengthened infrastructure, wider integration of telemedicine, and improved collaboration among emergency personnel to safeguard maternal and neonatal health in resource-limited rural settings.

Uterine-preserving vaginal sacrospinous hysteropexy in pelvic organ prolapse: a case series

2025-10-30T06:28:51+0530

Pelvic organ prolapse (POP) is a major cause of morbidity among women worldwide and is commonly managed by hysterectomy. However, uterine-preserving procedures such as vaginal sacrospinous hysteropexy (SSH) are increasingly being adopted, particularly where cultural and psychological considerations make uterine conservation desirable. We report our experience with SSH in Northern Nigeria as a case series. This series involved 26 women with symptomatic POP who underwent SSH between 2015 and 2024 across different locations in Northern Nigeria. The mean age of the women was 40 years and the modal parity was 2, with most women presenting with advanced prolapse (POP-Q stage IV). All women reported protrusion per vaginam as their main complaint. The mean operating time was 31 minutes, mean blood loss was 171 mL, and mean duration of hospital stay was three days. Early complications were recorded in two patients (7.6%): one case each of postoperative bleeding and urinary retention. Recurrence was observed in two patients (7.6%) during follow-up. Outcomes were comparable to those reported in similar studies, with relatively short operative times, low blood loss, and acceptable recurrence rates. Our findings suggest that SSH is a safe, effective, and culturally acceptable option for uterine preservation in women with advanced POP in low-resource settings. Wider use of this technique could improve access to surgical care and enhance the quality of life of affected women, particularly where resources and surgical expertise are limited.

Diverse feto-maternal presentations of chorioangioma: a case series

2025-10-30T06:27:21+0530

Placental chorioangioma is the most common benign non-trophoblastic tumor of the placenta, originating from primitive chorionic mesenchyme and typically being vascular. It has an incidence of 0.6-1% among all pregnancies. The size of the lesion remains the most important factor in prognosis, with small tumors often going unnoticed through the pregnancy without any fetal or maternal complications. Larger lesions (more than 4-5 cm) usually present early in pregnancy and can lead to significant maternal and fetal issues. Late presentation allows more time for fetal maturity and is associated with a lower perinatal mortality rate. Ultrasonography and color Doppler imaging are the main diagnostic tools for placental chorioangioma, showing hypo- and hyper-echoic lesions with vasculature connected to the fetal vascular system. Fetal complications, if they occur, may require intrauterine interventions. We present a series of four cases presenting at different gestational ages with diverse fetal and maternal clinical features and outcomes.

Broad ligament fibroid-clinical presentation and surgical challenges: a case series

2025-10-30T06:28:56+0530

Uterine leiomyomas are benign monoclonal tumors originating from smooth muscle tissue. Their classification is based on anatomical location, with each type presenting unique surgical challenges, particularly in cases involving large, long-standing fibroids in atypical positions. These challenges often stem from limited access to the operative field, distorted pelvic anatomy, difficulty in performing surgical repairs, and increased risk of blood loss. Managing such complex fibroids requires both surgical expertise and refined technique, especially when performing intricate hysterectomies. In this case series of five patients, we examine the varied presentations of broad ligament fibroids, associated clinical findings, and the operative difficulties encountered. Tailored approaches are essential, as each fibroid type demands a specific surgical strategy. Preoperative imaging for fibroid mapping, along with ureteric stenting when indicated, plays a crucial role in minimizing intraoperative complications. Adherence to established surgical principles ensures optimal outcomes, reduces the risk of urinary tract injury, and helps control blood loss during surgery.

Preservation of fertility in men with cancer

2025-10-30T06:30:27+0530

Fertility preservation in males is acknowledging a developing recognition as essential in treatment planning for cancer. Many currently available cancer therapies including chemotherapy, radiation and novel immunotherapy can affect sperm production, testicular function and reproductive potential. Although sperm cryopreservation is the gold standard for patients, considering post pubertal patients, experimental approaches to preserve fertility including cryopreservation of testicular tissue as an option for prepubertal boys, are in development. Whilst we do not currently lack options, several barriers prevent patients from timely access to fertility counselling, primarily a lack of awareness at their diagnosis or timely education of specific services. Early access to fertility preservation services as part of oncology health care can improve reproductive outcome and enhance long-term quality of life for survivors. Changes in our current practices will require better communication, collaboration, and a focus on improving patient access to fertility preservation options.

Sperm selection techniques in assisted reproduction: a comprehensive review

2025-10-30T06:28:45+0530

Sperm selection plays a pivotal role in assisted reproductive technology (ART), directly influencing fertilization rates, embryo development and overall clinical outcomes. While conventional methods such as swim-up and density gradient centrifugation methods are in clinical practice, they offer limited precision in identifying spermatozoa with optimal functional ability and DNA integrity. In response to these limitations, a range of advanced sperm selection techniques has emerged, aiming to improve the selection of high-quality spermatozoa. This review explores the principle, methodologies and clinical evidence behind both established and emerging sperm selection methods. Techniques discussed include magnetic-activated cell sorting (MACS), microfluidic sperm sorting (MSS), hyaluronic acid binding assay/ physiological intracytoplasmic sperm injection (HBA/PICSI) and high-magnification selection methods like intracytoplasmic morphologically selected sperm injection (IMSI). Additionally, novel technologies such as Raman spectroscopy, polarized light microscopy and surface charge-based selection (Zeta potential) are examined for their potential applications in reproductive medicine. While early results suggest these advanced methods may enhance ART outcomes, particularly in cases of male factor infertility, further large-scale randomized controlled trials are needed to confirm their clinical utility and define their optimal use. This review aims to provide ART practitioners with a comprehensive overview of the evolving landscape of sperm selection in ART, highlighting both current practices and future directions.

Misoprostol: history and clinical aspects

2025-10-30T06:27:37+0530

Misoprostol, a synthetic prostaglandin E1 analog, was originally developed for NSAID-induced gastric ulcers and is now widely used in obstetric and gynaecologic procedures. It acts as a prodrug, rapidly converted in the liver to misoprostol acid, which binds EP-3 receptors to induce uterine contractions. Misoprostol is effective for medical abortion, postpartum hemorrhage prevention, labour induction, cervical preparation and reducing blood loss during gynaecologic surgeries. Administration routes include oral, sublingual, buccal, rectal and vaginal, with dosing tailored to indication and gestational age. Adverse effects are generally mild but may include diarrhoea, nausea, fever and rarely, uterine rupture or teratogenic effects. Contraindications include prostaglandin hypersensitivity and advanced pregnancy with prior uterine scars. Overall, misoprostol is a versatile, generally safe drug with significant clinical applications in reproductive health.

Current nursing and midwifery role in shaping digital health policy and practices for nursing professionals: an integrative systematic review

2025-10-30T06:30:21+0530

As healthcare systems undergo rapid digital transformation, nursing and midwifery professionals are increasingly positioned to shape digital health policies and practices, yet their roles often remain fragmented and underrecognized. This integrative review, conducted under the PRISMA framework, synthesized evidence from five databases (PubMed, Scopus, Web of Science, CINAHL, and Google Scholar) covering 2015-2025, with quality assessment guided by MMAT and CASP. Out of 2,184 records screened, 10 studies met inclusion criteria, revealing four key areas of contribution: digital health leadership and advocacy, clinical informatics and data stewardship, participation in policy development, and digital education and literacy enhancement. Despite these contributions, barriers such as limited digital competencies, exclusion from policymaking, and institutional inertia persist. Overall, the findings underscore the vital yet underleveraged influence of nurses and midwives in digital health governance. To optimize their impact, systemic enablers including leadership pathways, digital education reforms, and stronger interdisciplinary collaboration are essential, ensuring these professionals can effectively contribute to equitable and transformative healthcare systems.

Postpartum depression among women: a systematic review of prevalence, risk factors, and maternal outcomes

2025-10-30T06:27:35+0530

Postpartum depression (PPD) was the most common psychiatric complication that followed childbirth, but it often remained undiagnosed and untreated across many regions of the world. Its prevalence differed greatly, depending on the characteristics of the population studied, the screening tools used, and the influence of cultural context. This review, conducted under PRISMA guidelines, synthesized findings from 10 peer-reviewed studies released between 2012 and 2023. Searches were conducted in PubMed, Scopus, and Web of Science. Only original observational studies evaluating PPD prevalence, identifying risk factors, and reporting maternal outcomes with validated tools were included. Extracted information covered study aspects, prevalence values, and risk factors, and narrative synthesis was applied. In the 10 included studies, which had sample sizes between 350 and 12,198, the prevalence of PPD ranged from 7.3% to 30.3%. Recurrent risk factors identified were low education, unemployment, unmarried status, cesarean birth, unplanned pregnancy, preterm delivery, absence of breastfeeding plans, low Apgar scores, poor partner support, and past psychiatric conditions. Protective influences included higher education, partner support, and effective breastfeeding. PPD was recognized as a worldwide maternal health challenge, with prevalence rates reported up to 30%. The review stressed the need for routine screening programs, culturally responsive interventions, and policies aimed at social determinants of maternal well-being.

Master’s programs in midwifery education in South Asia: organizational frameworks, competency goals, and learning outcomes

2025-10-30T06:28:50+0530

South Asia continues to experience a disproportionate burden of preventable maternal and neonatal morbidity and mortality, while countries in the region are simultaneously accelerating midwifery reforms through advanced education pathways. Over the past decade, several South Asian countries have introduced or proposed master’s-level midwifery programs, often aligned with international confederation of midwives (ICM) competencies and world health organization (WHO) quality standards. This review synthesizes the current landscape of master’s programs in midwifery education across South Asia (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka), examining organizational frameworks, competency goals relative to global benchmarks, and evidence on learning outcomes, implementation challenges, and policy alignment. A systematic review of peer-reviewed literature, national regulations, policy documents, and program webpages (2010-August 2025) was conducted, prioritizing authoritative sources including ICM, WHO, UNFPA, national acts, council guidelines, and university curricula. Data extraction focused on program typology, credit requirements, theory-practice ratios, competency frameworks, assessment modalities, and documented outcomes. Findings indicate regional convergence around ICM global standards for midwifery education (2021) and ICM essential competencies (2024), including minimum program durations (36 months direct-entry; 18 months post-nursing) and recommended theory/clinical ratios (40%/≥50%). India’s midwifery reforms (Guidelines on midwifery services, NPM educator programs, NNMC act 2023) provide a scalable national framework; Nepal offers a dedicated M. Sc. in Midwifery at Kathmandu university; Bangladesh is developing in-country master’s provision; and Pakistan emphasizes MSN tracks with maternal-neonatal specialization. Establishing a regional master’s archetype anchored in ICM/WHO standards, supported by robust clinical partnerships, OSCE-based assessment, and research-to-policy integration, can accelerate safe, respectful, and evidence-based maternity care across South Asia.

Determinants of contraceptive choices among young females in northern Nigeria

2025-10-30T06:30:23+0530

Background: Reproductive health is vital to societal wellbeing, and in Nigeria, home to one of the largest youth populations, understanding the factors influencing contraceptive choices is crucial for improving access and uptake. This study assessed determinants of contraceptive choices and patterns of uptake among young female undergraduates in northwestern Nigeria.

Methods: It was a descriptive, cross-sectional survey. The study was conducted among 400 female undergraduates of Ahmadu Bello University, Zaria, selected through a multistage sampling technique. Data were collected using a structured, pretested questionnaire administered by trained assistants. Analysis was performed with SPSS version 25.0.

Results: Of 400 questionnaires, 360 were completed, yielding a 90% response rate. Most respondents were single and aged 21-25 years. The oral contraceptive pill (20.3%) and male condom (18.9%) were the most commonly used methods. Availability (32.2%) influenced method choice, while safety (34.7%) was the most important determinant of use. Although 70% reported easy access to contraceptives, primary sources were patent medicine stores (25.8%), partners (22.7%), and parents (17.2%). Barriers included inadequate knowledge of proper use (24.4%) and fear of side effects (28.3%). Broader impediments were personal reasons, limited information, health system gaps, and negative provider attitudes. Marital status significantly influenced contraceptive use (p<0.001), while both marital status (p=0.04) and residence (p<0.001) determined consistency of use.

Conclusions: Contraceptive choice remains a key issue for young women. Enhancing availability, safety, clarity of use, and confidence in efficacy could substantially improve uptake among this population.

Maternal and neonatal morbidity associated with higher-order of four or more repeat cesarean sections: a retrospective cohort analysis in Dubai

2025-10-30T06:30:26+0530

Background: Cesarean delivery rates have surged globally over the past few decades, with an increasing trend of repeat cesarean sections (CS), raising significant maternal and neonatal health concerns. The risks associated with higher-order (four or more) repeat cesarean deliveries are underexplored, especially concerning outcomes like maternal hemorrhage, uterine rupture, placenta accreta spectrum (PAS), and neonatal morbidity. This study aimed to analyze maternal and neonatal morbidity in women undergoing higher-order repeat cesarean sections, comparing these with outcomes in lower-order (three or fewer) CS deliveries, to provide insights for risk mitigation and informed decision-making.

Methods: A retrospective cohort study was conducted on patients who underwent repeat cesarean deliveries from January 2018 to December 2023. Data were gathered from electronic health records, focusing on key outcomes including maternal complications (e.g., blood transfusions, adhesions, ICU admissions) and neonatal complications (e.g., NICU admissions, respiratory distress). Statistical analysis was used to assess correlations and compare morbidity

outcomes between groups.

Results: Findings indicated significantly higher morbidity in the higher-order CS group. Elevated risks of hemorrhage, peripartum hysterectomy, organ injuries, and neonatal NICU admissions were observed. These findings highlight the need for enhanced clinical strategies and informed counselling for women with multiple prior cesarean sections.

Conclusions: This study underscored the increased maternal and neonatal risks associated with four or more repeat cesarean sections. These results support the importance of careful prenatal monitoring, informed patient counselling, and targeted interventions to mitigate risks for high-order repeat cesarean deliveries.

Laparoscopic management of ectopic pregnancy: a 34-month retrospective study at Amath Dansokho Regional Hospital Center, Kédougou, Senegal

2025-10-30T06:28:58+0530

Background: Ectopic pregnancy (EP) is a major gynecological emergency with significant incidence in rural settings where access to care is limited. Laparoscopic surgery is now recognized as the reference technique for EP treatment. This study reports the experience of the Amath Dansokho Regional Hospital Center of Kédougou in the laparoscopic management of EP.

Methods: A retrospective descriptive study was conducted on 30 patients operated by laparoscopy for EP between September 2022 and July 2025 at Amath Dansokho Regional Hospital Center, a rural level II hospital located 800 km from Dakar. Sociodemographic, clinical, surgical data and postoperative outcomes were analyzed.

Results: The mean age of patients was 26.3 years. The majority of EPs were located on the left fallopian tube (53.3%) and ruptured in 70% of cases. The laparoscopic management rate for EP was 71.4%. Anterograde salpingectomy was the main procedure in 80% of interventions. Postoperative outcomes were favourable with no conversion to laparotomy and an average hospital stay of 2 days.

Conclusions: Laparoscopy is a safe and effective technique for managing EP in rural settings, reducing morbidity and hospital stay. Its development in resource-limited areas requires capacity building and adequate training of medical teams.

Prevalence and associated factors of preeclampsia in two national university hospitals in Cotonou in 2024

2025-10-30T06:28:59+0530

Background: Preeclampsia is one of the direct obstetric complications with a heavy burden, particularly in low- and middle-income countries such as Benin. The objective of this research was to identify the determinants of preeclampsia among pregnant women managed in two national university hospitals in Cotonou in 2024.

Methods: The study was conducted in two university hospitals in Cotonou. It was a matched case-control study (two controls for each case), with an analytical aim and prospective data collection from August to October 2024. The threshold for retaining variables in the bivariate analysis was 0.2. Multivariate analysis consisted of a stepwise descending binary logistic regression with a significance level of 0.05.

Results: A total of 120 cases of preeclampsia and 240 controls were surveyed. The hospital prevalence of preeclampsia was 11.11%. The mean age was 27.64±6.32 years versus 27.35±5.72 years. Most participants had secondary education (33.33% versus 42.50%) and were nulliparous (45.83% versus 35.42%). The majority of cases were referred (84.17%). Preeclampsia had several determinants: acceptance of the pregnancy by the partner (p=0.013), recent change of partner (p<0.001), existence of stress during pregnancy (p=0.006), nulliparity (p = 0.034), difficult living conditions (p=0.014), place of antenatal care (p<0.001), and multiple pregnancies (p=0.002).

Conclusions: Identifying the determinants of preeclampsia will make it possible to target appropriate interventions and preventive measures to reduce its incidence, tailor antenatal care, and improve the maternal and perinatal prognosis of this condition.

Assessment of knowledge, enablers, and barriers to healthcare-seeking behaviours for urinary tract infections among pregnant women at Banadir Maternal and Child Hospital, Somalia

2025-10-30T06:27:39+0530

Background: Urinary tract infections (UTIs) are common during pregnancy causing serious issue to both maternal and infantile health. However, little research has been conducted regarding what women know and do about UTIs in Somalia.

Methods: A cross sectional mixed-methods approach was employed in this study to obtain both quantitative data and qualitative findings of women knowledge, experiences, and health-seeking behaviours related to UTIs. Between August and December 2024, 200 women participated in a quantitative survey, among which 21 were selected for qualitative interviews.

Results: The majority (55%) of women reported having symptoms related to UTI, with the most common symptoms being fever or chills (54%), lower abdominal pain (50%), and frequent urination (42%). Only 33.5% had tested positive for UTIs in their urine. Before seeking medical attention, a large percentage of women (51%) turned to traditional remedies, such as camel milk and herbal teas. The main obstacles to accessing healthcare were transportation concerns (20.5%) and financial limitations (49.5%). Some people believed that spiritual factors caused UTIs, while others believed that poor hygiene (43%) or sexual activity (41.5%) were the main causes. The qualitative analysis revealed that people's understanding of UTIs varied; many were aware of the symptoms but not the causes or complications. Cultural factors influenced healthcare-seeking, with women frequently avoiding medical care out of fear of judgment and stigma.

Conclusions: The study underscores the need of better UTI education; the integration of biomedical and traditional practices can help in early detection and seeking healthcare at the appropriate time.

Evaluating a synergistic nutritional strategy in women with polycystic ovary syndrome: a multicentric retrospective analysis

2025-10-30T06:28:59+0530

Background: The objective of this study was to review clinical outcomes in women with polycystic ovary syndrome (PCOS) following 3-6 months of treatment with the marketed formulations containing insulin sensitizers, minerals, herbal extracts, amino acids, antioxidants, and vitamins.

Methods: An observational study was conducted to retrospectively review clinical records of women diagnosed with PCOS (age 15-42 years; n=211) at 14 fertility clinics in India between April 2024 and February 2025. From the day of PCOS diagnosis, patients received marketed formulations containing (1) insulin-sensitizing agents, antioxidants, and vitamins and (2) fertility blend containing herbal extracts, amino acids and minerals administered as two tablets daily for 3 to 6 months. The primary outcomes assessed were improvements in PCOS symptoms such as (menstrual cyclicity, acne, and hirsutism), body mass index (BMI), waist-to-hip ratio, ovarian cyst count, hormonal profile, and clinical pregnancy rates.

Results: Combination therapy significantly improved menstrual cyclicity in both obese (40% at 3 months; 80.56% at six months) and lean (42.30% at three months; 69.23% at 6 months) PCOS women. Significant reductions in acne, hirsutism, and ovarian cysts were observed across both the groups. Additionally, metabolic parameters and hormonal profiles improved significantly. The clinical pregnancy rate increased to 36.78% at three months and 65.16% at six months in obese women, while lean women showed rates of 38.46% and 53.84% respectively.

Conclusions: The combination of inositols, antioxidants, herbal extracts, amino acids, minerals, and vitamins offer a promising and clinically relevant treatment option for PCOS management, demonstrating significant benefits in metabolic, hormonal, and reproductive health.

Panicker’s vacuum suction hemostatic device- a novel innovation for the treatment of atonic postpartum hemorrhage

2025-10-30T06:28:55+0530

Background: The aim of this study was to evaluate the effectiveness of the Panicker’s vacuum suction hemostatic device in treating postpartum hemorrhage refractory to medical treatment.

Methods: A retrospective study including women with atonic postpartum hemorrhage in whom Panicker’s vacuum suction hemostatic device was used, since they did not respond to the medical management. The demographic factors, mode of delivery, volume of blood loss, blood transfusion and outcome of the procedure were studied.

Results: The study demonstrated that the device achieved effective hemostasis in both minor and major PPH, helping reduce maternal morbidity and mortality. Early recognition and timely preventive measures in at-risk women could have limited bleeding and reduced the need for transfusions.

Conclusions: Panicker’s vacuum suction hemostatic device which works on the principle of vacuum retraction of the uterus was found to be effective in the management of atonic postpartum hemorrhage.

Family planning barriers and enablers among displaced Somali women in Ali Addeh Camp, Djibouti

2025-10-30T06:27:38+0530

Background: Sexual and reproductive health is essential to human rights, yet displaced populations, particularly women, face numerous barriers to accessing family planning services. This cross-sectional study aimed to explore the barriers and enablers of contraceptive use among Somali refugee women in the Ali Addeh Refugee Camp, Djibouti.

Methods: A qualitative, exploratory design was used, incorporating focus group discussions (FGDs) with Somali refugee women. A total of 49 women participated, organized into seven groups based on marital status and age. Thematic analysis was conducted, focusing on barriers, enablers, and social dynamics related to family planning.

Results: Major barriers cited were religious opposition, misinformation, and sociocultural resistance. Interestingly, 79.6% of the respondents desired large families, 67.3% of whom desired 18 to 35 months of birth spacing. While 40.8% of the women had 1-2 children, 34.7% of the women had five or more children. Contraception was viewed as foreign or religiously prohibited by most women, and 22 women cited religion. Male endorsement of family planning decisions was present, with 27 women reporting that spousal disapproval was a significant deterrent. Privacy concerns were common, with 18 women reporting stigma and fear of judgment among healthcare providers. Despite such barriers, trust in healthcare providers, religious endorsement, and community outreach were reported as facilitators of family planning.

Conclusions: The study underscores the need for men and religious leaders' involvement in family planning. Interventions for displaced women should also prioritize privacy in health facilities, accessible and culturally acceptable family planning services.

Analysis of caesarean section rates in Malta using the Robson ten-group classification system

2025-10-30T06:28:53+0530

Background: Caesarean section (CS) rates continue to rise globally. In Malta, the rate of caesarean deliveries has increased by eight percentage points over the past two decades. The World Health Organization recommends the use of the Robson classification as a global standard for monitoring and auditing CS. This study aimed to examine CS rates in the Maltese Islands across two time periods using the Robson classification.

Methods: A retrospective, registry-based study was conducted covering all deliveries between 2009-2013 and 2019-2023. Women undergoing childbirth in Malta and Gozo were allocated to one of the 10 Robson groups. Changes in overall CS rates and contributions by Robson group between the two periods were analysed using significance tests. Indications for CS were analysed for 2019-2023.

Results: A total of 42,585 deliveries were analysed across both periods. Despite more advanced maternal age and a higher proportion of non-Maltese mothers over the time periods, the CS rate remained stable (31.9% in 2009-2013; 32.6% in 2019-2023). Contributions to the overall CS rate of Robson groups 5 (previous CS), 6 and 7 (breech) increased significantly, whilst contributions of groups 1 (nullipara, spontaneous labour), 2 (nullipara, induction/pre-labour CS), 8 (multiple pregnancies), and 10 (preterm) decreased significantly between study periods. The top contributors remained Robson groups 5 and 2, followed by 1.

Conclusions: The Robson classification allows identification of the obstetric populations driving CS use. Our study findings provide a starting point for auditing of obstetric practices with a view to reducing CS rates.

Prevalence, immediate neonatal outcomes, and factors associated with short birth intervals among mothers delivered at Mubende Regional Referral Hospital, Uganda

2025-10-30T06:28:47+0530

Background: Short birth intervals (SBIs) pose significant public health risks, particularly in low-resource settings like Uganda, where they are associated with adverse neonatal outcomes. Despite WHO recommendations for optimal birth spacing, high rates of SBIs persist, largely due to socio-economic, cultural, and healthcare access challenges. This study aimed to determine the prevalence, immediate neonatal outcomes, and associated factors of SBIs among mothers at Mubende Regional Referral Hospital.

Methods: A cross-sectional study was conducted from May to August 2024, involving 422 postpartum mothers. Data on sociodemographic, obstetric, and behavioral factors were collected, and logistic regression analysis was used to identify factors associated with SBIs and assess the impact on neonatal outcomes, including small for gestational age, preterm birth, early neonatal death, and External congenital defects.

Results: The study revealed an SBI prevalence of 40.3%. The most common adverse neonatal outcomes were Small for gestational age (31%), and preterm birth (26%). Key factors associated with SBIs included young maternal age (<20 years, aOR 2.18, 95% CI: 1.13-4.22), rural residence (aOR 2.84, 95% CI: 1.69-4.78), lack of antenatal care (aOR 4.64, 95% CI: 1.80-11.95), unplanned pregnancies (aOR 2.15, 95% CI: 1.35-3.41), and short breastfeeding duration (<12 months, aOR 3.26, 95% CI: 2.05-5.20).

Conclusions: The study identified a high prevalence of SBIs, with significant associations to adverse neonatal outcomes such as Small for gestational age, and preterm birth. Factors contributing to SBIs included young maternal age, rural residence, limited antenatal care, and unplanned pregnancies, are highlighting the need for targeted family planning and maternal health interventions.

Evaluation of a therapeutic combination to prevent ovarian hyperstimulation syndrome

2025-10-30T06:28:46+0530

Background: Ovarian hyperstimulation syndrome (OHSS) remains a significant iatrogenic complication in assisted reproductive technology. Various strategies have been proposed to minimize its occurrence, particularly in high-risk patients. To evaluate the effectiveness of a combined preventive protocol including GnRH antagonist protocol, GnRH agonist trigger, dopamine agonist (cabergoline), calcium infusion, and a freeze-all strategy in reducing the incidence of OHSS without compromising IVF outcomes.

Methods: A comparative study was conducted on women undergoing IVF, divided into a study group receiving the combined protocol and a control group managed conventionally. Primary outcomes included stimulation parameters, incidence of OHSS, and biochemical pregnancy rates. Secondary outcomes assessed included the number of cumulus-oocyte complexes (COCs), mature oocytes (MII), and vitrified embryos.

Results: The study group showed significantly lower gonadotropin doses, with improved ovarian response reflected by higher numbers of COCs, MII oocytes, and vitrified embryos (p<0.05). Despite these improved biological outcomes, β-hCG positivity rates did not differ significantly between the two groups (24% vs. 26.5%; p=0.239). No cases of moderate or severe OHSS were observed in the study group.

Conclusions: The combined use of multiple evidence-based strategies appears effective in reducing the risk of OHSS while maintaining satisfactory IVF outcomes. This multifaceted approach may offer a safer stimulation pathway for high-risk patients without compromising pregnancy potential.

Modern contraceptive method utilization among mothers of children aged 7 to 24 months at the Yalgado Ouédraogo University Hospital, Burkina Faso, West Africa

2025-10-30T06:28:44+0530

Background: This study aimed to examine the use of modern contraceptive methods among mothers of children aged 7 to 24 Months at Yalgado Ouédraogo University Hospital (CHU-YO) in Ouagadougou, Burkina Faso.

Methods: An analytical cross-sectional survey was conducted among 412 women who had delivered at CHU-YO and whose infants were between 7 and 24 months of age. A structured questionnaire was used to collect data on sociodemographic characteristics, obstetric history, and modern contraceptive use. Data analysis using R software identified associations between modern contraceptive use and various factors.

Results: The study found a 69.2% prevalence of modern contraceptive use among participants. The progestin implant and intrauterine device (IUDs) were the most commonly used methods. Factors associated with modern method use included age over 30 years, higher level of education, having at least two living children, having received family planning counseling, and having given birth by cesarean section. Factors associated with the use of long-acting methods in the multivariate analysis were being married, having received family planning counseling during pregnancy or in the postpartum period, having had a cesarean delivery, and being overweight (BMI ³ 24.5 kg/m²). Factors associated with the use of hormonal methods in multivariate analysis were having received family planning counseling during pregnancy or in the postpartum period and having had a vaginal delivery.

Conclusions: The use of modern contraceptive methods was higher among mothers of children aged 7 to 24 months than in the general population. However, factors such as age, level of education and having received family planning advice influenced women's contraceptive use. Health professionals need to explore ways to further improve the use of modern contraceptives.

Asymptomatic bacteriuria in HIV positive and negative pregnant women at Federal University Teaching Hospital Lafia: a comparative study

2025-10-30T06:27:34+0530

Background: Pregnant women with asymptomatic bacteriuria (ASB) are at increased risk of complicated urinary tract infection. The prevalence and risk of progression may be higher with background human immunodeficiency viral (HIV) infection. The aim of the study was to compare the prevalent microbial isolates and antibiotic sensitivity pattern in asymptomatic bacteriuria among HIV positive and negative antenatal clients in Federal University Teaching Hospital (FUTH), Lafia.

Methods: A cross sectional comparative study carried out among 60 HIV positive and negative antenatal women respectively at the obstetric unit of FUTH, Lafia, Nasarawa state. Relevant Socio-demographic and clinical data were collected using structured proforma. ‘Clean catch’ midstream urine samples were collected from each subject and microbial culture and sensitivity test were carried out and analysis done using SPSS version 22. A p-value of less than 0.05 was accepted as statistically significant.

Results: The overall prevalence of ASB in both groups was 53.3% with a higher prevalence of 54.7% HIV positive compared to the prevalence of 45.3% in HIV negative pregnant women. Echerechia coli were the commonest organisms isolated and majority of the organism isolated were gram negative. Ciprofloxacin was the antibiotics with the best sensitivity. However, there is a marked resistance of greater than 50% of all the drugs.

Conclusions: Though there is high prevalence of ASB in HIV positive women than the HIV negative pregnant women, there was no statistically significant difference in prevalence, microbial isolates and antibiotic sensitivity in the two groups.

Determinants of the use of modern contraceptive methods among women of reproductive age in a health zone in southern Benin

2025-10-30T06:28:48+0530

Background: The prevention of unintended pregnancies is one of the essential pillars of reducing avoidable maternal deaths. However, contraceptive prevalence remains low in Benin in general, and particularly in the Allada-Toffo-Zè health zone. Objective was to identify the determinants of the use of modern contraceptive methods among women of reproductive age in the Allada-Toffo-Zè Health Zone.

Methods: This was a cross-sectional study with descriptive and analytical purposes, based on prospective data collection from March 6 to May 31, 2023, conducted in ten (10) health facilities within the Allada-Toffo-Zè health zone located in southern Benin. All women of reproductive age (15-49 years old) who attended consultations and provided informed consent were included and interviewed through a face-to-face structured questionnaire. Logistic regression analysis was performed to assess the association between explanatory variables and the outcome variable, which was the use of modern contraceptive methods, with a significance level set at 5%.

Results: A total of 402 women were surveyed. The prevalence of modern contraceptive use was 20.79%. The mean age was 28.25±7 years. The determinants of modern contraceptive use were parity (p=0.014), knowledge of the effectiveness of contraceptive methods (p<0.001), knowledge about birth spacing by the method (p<0.001), insurance for the prevention of sexually transmitted infections by the method (p=0.008).

Conclusions: Understanding the determinants of modern contraceptive use will help target relevant interventions to improve contraceptive prevalence and contribute to accelerating the reduction of maternal mortality in the health zone.

Prevalence of dysmenorrhea and intention to seek care among in-school adolescents in Nigeria: a cross-sectional study

2025-10-30T06:27:33+0530

Background: Dysmenorrhea is a problem that girls face and often manage themselves with or without support from health professionals. The objective of this study was to assess the prevalence of dysmenorrhea and intentions to seek care among in-school adolescents.

Methods: Descriptive cross-sectional research design was utilized, and a two stage sampling technique was used in selecting 315 participants based on the required sample size. Data were analyzed using SPSS version 20, and results were summarized using descriptive and inferential statistics with level of significance set at p<0.05.

Results: The mean age of respondents was 15.49±1.44 years. Dysmenorrhea was prevalent among 80% of the respondents. Predictors of intention to seek care for dysmenorrhea among the respondents were awareness about health services for dysmenorrhea (AOR=2.15, 95%CI=1.19-3.86, p=0.012), cost of care for dysmenorrhea (AOR=0.29, 95%CI=0.12-0.62, p=0.002), and perception on dysmenorrhea (AOR=0.21, 95%CI=0.10-0.40, p=0.001).

Conclusions: Dysmenorrhoea is a common health problem among in-school adolescents in Nigeria. Health education campaigns should be organized to create awareness on availability of services for treatment of dysmenorrhea and correct the misconception that dysmenorrhea needs no care especially in situations where the pain is moderate to severe.

Psychosomatic disorders with predominantly gynecological complaints: a clinical and demographic profile study at a tertiary care center

2025-10-17T08:41:35+0530

Background: Psychosomatic disorders, particularly somatic symptom disorders (SSD), represent a significant challenge in clinical practice due to their complex interplay of psychological and physical symptoms. Women frequently present with unexplained gynecological symptoms, often impacting their quality of life and leading to multiple healthcare consultations. This study aims to evaluate the prevalence and symptom profile of SSD in women attending a gynecology outpatient department (OPD).

Methods: A cross-sectional study was conducted over 12 months in the department of obstetrics and gynecology at the Himalayan institute of medical sciences, Dehradun. Seventy-two women aged ≥18 years with unexplained gynecological symptoms persisting for >6 months were recruited. Detailed history, clinical examination, and investigations were performed to exclude organic causes. The public health questionnaire-15 (PHQ-15) was used to assess symptom severity. Data were analyzed using SPSS version 20.

Results: Out of 6000 gynecology OPD attendees, 1.2% (72 patients) were diagnosed with SSD. The most common symptoms were chronic pelvic pain (56.94%), vaginal discharge (37.5%), and lower backache (26.38%). The majority (45.83%) of patients were aged 40-59 years, and 56.9% had a normal BMI. Parity of three was most common (44.44%), and 34.72% had a history of primary education. Psychiatric comorbidities were present in 34.72%, with depression being the most frequent (13.88%). Hypothyroidism (13.88%) was the most common comorbidity. PHQ-15 scores indicated that 38.88% had moderate severity of symptoms.

Conclusions: SSD is an underrecognized but significant concern among women with unexplained gynecological symptoms. Chronic pelvic pain and vaginal discharge were the most prevalent symptoms. A multidisciplinary approach, including psychiatric evaluation, is essential for effective management of these patients.

Four years, single surgeon, 114 robotic gynecological surgeries: an institutional audit from India with the Cambridge medical robotics Versius robot

2025-10-30T06:27:29+0530

Background: Robotic-assisted surgery is transforming minimally invasive gynecology by offering enhanced precision, superior visualization, and ergonomic advantages over conventional laparoscopy. The Versius surgical system is a newer, modular alternative with lower infrastructure needs. However, published evidence on Versius use in gynecological surgery, particularly from India, is limited. This study evaluates a single-centre, single-surgeon experience with the Versius system over four years. Objectives were to assess the safety, feasibility, and effectiveness of robotic gynecological surgeries performed using the Versius system at a tertiary hospital in Delhi, India, over a 4-year period.

Methods: A retrospective review covered 114 consecutive benign gynecological procedures performed using Versius between July 2021 and July 2025 at PSRI hospital, Delhi. Data on patient demographics, surgical types, operative times, blood loss, complications, and hospital stay were analyzed.

Results: Robotic hysterectomy was the most common procedure (61.4%), followed by myomectomy (15%) and endometriosis surgery (12%). The mean operative time for hysterectomy was 174 minutes. Blood loss was ≤100 mL in 78% of cases. Intraoperative complications occurred in 7.9%, primarily hemorrhage, with two conversions to open or laparoscopic surgery. Postoperative recovery was uneventful in 97.5%, with a mean hospital stay of 1.08 days; most (91%) were discharged within 24 hours.

Conclusions: Versius robotic gynecological surgery is safe, feasible, and effective in an Indian tertiary setting, highlighting its promise as a cost-effective platform with low complications, minimal blood loss, and short hospital stays.

Evaluation of spot urine albumin creatinine ratio as a screening tool for prediction of preeclampsia

2025-10-30T06:27:28+0530

Background: Preeclampsia is the second leading cause of maternal mortality, accounting for approximately 12-18% of pregnancy-related deaths. Spot urine albumin creatinine ratio (UACR) underscores its significance as a practical tool for earlier detection and effective management thereby enhancing clinical outcomes for both mother and their infants.

Methods: Singleton pregnant women between 16 and 20 weeks of gestation attending the antenatal care (ANC) outpatient department (OPD) of GMC Akola were enrolled in this prospective study. The spot urinary albumin-to-creatinine ratio (UACR) was calculated for each case. All patients were placed under regular follow-up at 24 weeks, 28 weeks, 32 weeks, 34 weeks, 36 weeks, and subsequently on a weekly basis until delivery. Special attention was given to identifying the development of preeclampsia during the antenatal period and/or at the time of delivery.

Results: A UACR cutoff of 35.5 mg/mmol was identified as predictive of preeclampsia, with a significant association noted (p<0.0001). Diagnostic performance measures revealed a sensitivity of 85.1%, specificity of 91.4%, PPV of 82.6%, and NPV of 92.8%, suggesting high diagnostic accuracy.

Conclusions: The present study establishes that spot UACR, when measured between 16-20 weeks of gestation in asymptomatic pregnant women, serves as a highly sensitive and specific early screening tool for predicting the subsequent development of preeclampsia.

Impact of health education on women’s knowledge, attitude and practice regarding menopause in Karnataka

2025-10-30T06:27:26+0530

Background: Menopause represents an important change in a woman's life, frequently accompanied by various physical, emotional, and social alterations. In spite of its effects, numerous women, especially those in rural regions, do not have sufficient understanding and assistance. This study aimed to evaluate the impact of a health education program on knowledge, attitude, and practice (KAP) regarding menopause among women in Karnataka.

Method: A total of 340 women aged between 35 and 65 years were selected to participate in the study through systematic sampling methods. The study encompassed both pre-menopausal and post-menopausal women, while individuals who were unavailable or opted not to participate were excluded from the analysis. Initial data were collected regarding demographic information, health history, and reproductive status. Subsequently, an educational intervention was implemented, focusing on the symptoms of menopause, management techniques, and healthy lifestyle practices. The assessment of knowledge, attitudes, and practices (KAP) levels occurred before and after the intervention using structured interview schedule.

Results: At baseline, all participants exhibited inadequate knowledge regarding menopause. Following the intervention, only 7% retained a classification of poor knowledge, while 80% attained average knowledge and 13% achieved good knowledge. Positive attitudes increased from 22% to 74%, and negative attitudes declined from 78% to 26%. Instances of good practices improved from 7% to 36%, whereas instances of poor practices decreased from 93% to 64%. Notably, participation in yoga and meditation activities surged from 13% to 89%, alongside a significant enhancement in health-seeking behavior.

Conclusion: The health education program proved highly effective in enhancing KAP related to menopause. However, the initially low awareness emphasizes the need for sustained community-based educational initiatives and continued research to support women through menopausal transition.

A comparative study of antiphospholipid antibodies in preeclampsia and normotensive pregnant women

2025-10-19T08:14:53+0530

Background: Hypertensive disorders of pregnancy cause major portion of maternal morbidity, mortality and poor feto maternal outcome. Abnormal trophoblastic invasion changes are seen in placental development in preeclamptic mother. Preeclampsia harms mother and baby, causing complications like intrauterine fetal death (IUFD), fetal growth restriction (FGR), and preterm delivery. Antiphospholipid antibodies (APLA) trigger coagulation, complement activation, and impaired syncytiotrophoblast differentiation, contributing to preeclampsia development. The study compared Antiphospholipid antibodies (anti-β2GPI, anticardiolipin, lupus anticoagulant) in preeclampsia and normotensive pregnancies. Detecting APLA may help predict preeclampsia and guide timely, specific management for at-risk women.

Method: The present study was conducted in Hindu Rao Hospital, New Delhi from January 2021 to May 2022. It was an observational case-control study which involved 100 normotensive pregnant women and 100 preeclamptic women who met the inclusion criteria. Blood pressure was measured in sitting position, and women were classified as preeclamptic or normotensive. Antiphospholipid antibodies were tested by enzyme linked immunosorbent assay (ELISA) and analyzed in the Biochemistry department. The following tests, anticardiolipin antibodies (aCL)-IgM and IgG, anti-beta-2 glycoprotein-IgM and IgG B and dilute Russell's viper venom time (DRVVT) screened lupus anticoagulant were done; presence of any antibody was positive, outcomes compared.

Results: In this study, out of 100 preeclamptic patients, 20 were positive for APLA antibodies (9 were positive among non-severe preeclampsia and 11were positive among severe preeclampsia) and out of 100 normotensive pregnant women, 3 were positive for APLA antibodies. Receiver operating characteristic (ROC) analysis showed lupus anticoagulant had 93% sensitivity and 97% specificity. APLA positivity was linked to preeclampsia, FGR, preterm delivery, lower segment caesarean section (LSCS), and neonatal complications.

Conclusions: The study found APLA prevalence of 20% in preeclamptic (9% non-severe, 11% severe) and 3% in normotensive women. Anticardiolipin and lupus anticoagulant differed significantly (p<0.05), but anti-β2GPI showed no significant difference (p>0.05).

Knowledge, attitude and practice about human papilloma virus vaccination among medical students

2025-10-30T06:30:25+0530

Background: Human papilloma virus (HPV) is one of the most common sexually transmitted infections and a major etiological factor for cervical cancer, which remains a leading cause of morbidity and mortality among women worldwide. Although safe and effective vaccines are available, awareness and vaccination coverage remain suboptimal, especially among young adults. Medical students, as future healthcare providers, play a pivotal role in promoting HPV vaccination; therefore, understanding their knowledge, attitude, and practices (KAP) is essential.

Methods: A cross-sectional study was conducted among undergraduate medical students of JNU medical college, Jaipur. Data were collected using a structured, pretested questionnaire assessing participants’ knowledge about HPV infection and vaccination, their attitudes toward immunization, and their personal vaccination practices. The responses were analysed using descriptive statistics to determine awareness levels and the relationship between knowledge and vaccination behaviour.

Results: The study revealed that while a majority of students had heard about HPV and its association with cervical cancer, only a smaller proportion demonstrated adequate knowledge about the recommended age, dosage schedule, and target groups for vaccination. Attitude toward HPV vaccination was generally positive, but the actual practice of vaccination among students was low. A clear gap was observed between awareness and vaccine uptake.

Conclusions: Although medical students showed moderate awareness and positive attitudes toward HPV vaccination, poor vaccination practice highlights the need for targeted educational programs and inclusion of HPV-related content in the medical curriculum.

Comparison of the efficacy and safety of sublingual misoprostol (PGE1) versus intracervical dinoprostone (PGE2) for induction of labour: a prospective study

2025-10-30T06:30:33+0530

Background: Induction of labour is indicated when the benefits of induction to either mother or fetus outweigh those of pregnancy continuation. Various mechanical methods include use of extra amniotic saline infusion, artificial rupture of membranes, balloon tipped catheter, natural and synthetic laminaria or stretch sweep method. Pharmacological methods are mainly using prostaglandins either Dinoprostone (PGE2) or Misoprostol (PGE1). This study aimed to compare the efficacy and safety of sublingual Misoprostol (PGE1) versus intracervical Dinoprostone (PGE2) for induction of labour and to compare maternal and perinatal outcome in both groups.

Methods: In this study, 250 antenatal women with 35 weeks or more period of gestation with a single live fetus, cephalic presentation were included for induction of labour.125 women received 25mcg misoprostol sublingually (group A) and 125 women received 0.5mg of dinoprostone intracervically (group B).

Results: There was shorter induction to active phase interval (7.68±3.39 vs 11.42±5.43 hours), induction to delivery intervals (11.46±3.46 vs 16.23±5.61 hours) and less requirement of oxytocin augmentation (25.6% vs 73.6%) in misoprostol group than dinoprostone group. Mode of delivery, maternal and neonatal complications were similar in both groups.

Conclusions: Use of sublingual misoprostol in lower dose is a safe and cost-effective method for induction of labour.

Asymptomatic bacteriuria in pregnancy and its effect on maternal and fetal outcomes

2025-10-30T06:30:32+0530

Background: Asymptomatic bacteriuria is the most common infection encountered in pregnancy and can lead to multiple complications both in mother like acute pyelonephritis, sepsis and in the fetus like LBW, preterm labour, PROM, if left untreated. The present study was done to determine the current prevalence of ASB and its maternal and perinatal outcome.

Methods: A prospective cohort study was conducted at a tertiary centre on 150 antenatal females. Urine culture and sensitivity was conducted for each participant and the fetomaternal outcome between affected and unaffected women were compared and p value <0.05 was considered significant.

Results: 27 females had ASB making the prevalence of 18% out of which 12 (44.4%) cultures yielded Klebsiella and 15 (55.5%) samples were sensitive to nitrofurantoin. There was no significant increase in antenatal complications, mode of delivery, post natal complications, neonatal outcomes.

Conclusions: There is no significant risk associated with ASB, therefore the next question opens regarding the need for treatment.

The study of indications, morbidity and mortality in patients delivered outside and referred to a tertiary care hospital

2025-10-30T06:30:31+0530

Background: Emergency referral is critical to improving outcomes for time-sensitive conditions that underlie many unpredictable problems during pregnancy, delivery, and the postnatal period. This is especially true for poor, remote and rural populations where access to health services may be limited. So, this study evaluated the maternal and fetal outcomes in patients referred to a tertiary care hospital after delivery outside to note the commonest postpartum complications, morbidity and mortality indicators in terms of need of ICU, stay in hospital, need of dialysis, need of NICU. This paper described the application of a practical approach to the assessment of the burden of postpartum morbidity by means of postpartum referrals to tertiary centre.

Methods: The observational present study was done in department of obstetrics and gynecology, BJ Government Medical College, Sassoon Hospital Pune covering a period of 18 months in postpartum period.

Results: Study included 150 cases, out of these common reasons for referrals were pre-eclampsia/eclampsia (68%), post-partum hemorrhage (52.7%) and puerperal sepsis (26%) while anemia was observed in 70% cases.

Conclusions: This study underscored the significant impact that delivering outside of a tertiary care setting can have on maternal-fetal outcomes. Timely referral to tertiary care centers plays a pivotal role in reducing complications and improving survival rates. Enhancing the quality of care in peripheral healthcare facilities and ensuring prompt transfer protocols could prevent many of the adverse outcomes.

Evaluating combined therapy with myoinositol and D-chiro-inositol in infertility management across PCOS phenotypes: a comprehensive retrospective data analysis

2025-10-30T06:30:31+0530

Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting up to 20% of reproductive-aged women, often leading to infertility due to chronic anovulation. The condition has a multifactorial etiology involving genetic, hormonal, and metabolic factors, with insulin resistance being a key feature. The clinical presentation and therapeutic response can vary among different PCOS phenotypes. Myoinositol and D-chiro inositol has garnered attention as a potential insulin sensitizer with fertility-enhancing effects in women with PCOS. This study aimed to evaluate the impact of Myoinositol and D-chiro inositol treatment on fertility outcomes across different PCOS phenotypes, focusing on pregnancy rates and phenotype-specific responses.

Methods: A review of medical records from 200 women with PCOS treated at M2M Women’s Clinic between 2018 and 2020 was conducted. Each woman took a sachet twice daily containing 2 g of Myo-Inositol and 50 mg of D-Chiro-Inositol in a 40:1 ratio. They were grouped into four types (A, B, C, D) based on the Rotterdam criteria. Data on treatment specifics, fertility outcomes, and follow-up results were analysed, and Chi-square tests were employed to compare pregnancy rates across the phenotypes.

Results: Out of the 200 participants, 143 (71.5%) completed follow-up. The overall pregnancy rate was 70.6%, with rates of 70.4% in Phenotype A and 69.1% in Phenotype D. Phenotypes B and C achieved 100% conception rates; however, these findings were constrained by small sample sizes.

Conclusions: Myoinositol, in combination with D-Chiro-Inositol in the physiological 40:1 ratio, appears effective in improving fertility outcomes, particularly in Phenotypes A and D. Further research with larger sample sizes is warranted to validate these findings across all PCOS phenotypes and refine phenotype-specific treatment protocols.

Prevalence of lower urinary tract symptoms in antenatal women in a tertiary care teaching institute of Uttar Pradesh

2025-10-30T06:30:30+0530

Background: Lower urinary tract symptoms (LUTS) are common in pregnancy due to hormonal, anatomical, and physiological changes, posing risks for both maternal and fetal health. Early detection is critical to prevent complications such as pyelonephritis, preterm labor, and low birth weight. Aim was to determine the prevalence of lower urinary tract symptoms among antenatal women.

Methods: This cross-sectional observational study was conducted at MLN Medical College, Prayagraj, from October 2024 to March 2025. One hundred symptomatic antenatal women were assessed through detailed history, examination, and lifestyle evaluation. Women with pre-existing urological conditions, immunocompromise, or recent urinary instrumentation were excluded.

Results: Most participants were aged 25-29 years (42%), multigravida (82%), in the first trimester (67%), from lower middle socioeconomic backgrounds (68%), and urban areas (65%). The predominant symptom was burning sensation/pain during micturition (56%), followed by increased frequency (32%). While 65% consumed ≥2 liters water daily and 80% had >2000 kcal/day intake, LUTS remained prevalent. Lifestyle factors included exercise (49%), tobacco chewing (23%), and caffeine use (13%).

Conclusions: LUTS in pregnancy are prevalent even among women with adequate hydration and nutrition, suggesting multifactorial etiology. Routine screening, lifestyle counselling, and early management- especially in multigravida women in early gestation- are essential to reduce morbidity.

The prevalence and awareness of menopausal symptoms among perimenopausal and postmenopausal women visiting a tertiary care hospital

2025-10-30T06:30:29+0530

Background: The growing number of postmenopausal women has important implications for healthcare systems, as these women may face specific health concerns associated with menopause and ageing. The study aimed to know the prevalence and awareness of menopausal symptoms among perimenopausal and postmenopausal women visiting tertiary hospitals.

Methods: A cross-sectional design was used for data collection and analysis. Women aged 45 years and above in the perimenopausal and postmenopausal age groups were included. We utilised the menopausal rating scale questionnaire as a tool.

Results: A maximum percentage of women (73%) reported physical and mental exhaustion, bladder problems (66%), joint and muscular discomfort (61%), and irritability (59.66%). Additionally, 46.6% of women reported having hot flushes. Dryness of the vagina in 41.33%. Among the 45 to 55 years age maximum women had hot flushes (60.71%), the sexual problem (54.83%), irritability (54.74%), and depressive mood (32%). Among 56 to 65 years age the most common complaints were sleep disturbance (58.62%), bladder problems (45.96%), Anxiety (44.58%), physical and mental discomfort (40.63%), joint and muscular discomfort (39.89%), and vaginal dryness (36.29%). Among the 66 to 75 the heart discomfort was highest (45.67%). Among women aged 76 years and above, age depressive symptoms (16%) and sleep problems (13.79%) were present.

Conclusions: There is a high prevalence of menopausal symptoms and a lack of awareness among women, implying a need for healthcare initiatives in India, where this issue receives little attention. We strongly advocate a governmental policy for menopausal women to support their specific health needs.

Evaluation of risk factors for intrauterine foetal death during third trimester of pregnancy: a hospital-based cross-sectional study

2025-10-30T06:30:28+0530

Background: In most cases of intrauterine foetal death (IUFD) in which the aetiology is known, a recurrence risk can be determined, and sometimes prenatal diagnosis and prevention are possible. In the present study, we evaluated the risk factors for intrauterine foetal death during 3^rd trimester of pregnancy.

Methods: This was a hospital based cross sectional study, which was conducted in department of obstetrics and gynecology in tertiary Government Teaching Hospital in North Maharashtra for the period of 24 months. We enrolled 131 patients attending ANC OPD/labour room in their 3^rd trimester of pregnancy who were diagnosed to have IUFD.

Results: There were 131 stillbirths out of 6402 live births hence incidence of IUFD was 20 per 1000 birth. IUFD was maximum seen in age group of 21 to 35 years (83.2%). Mortality was higher in un-booked cases (81.7%) and maximum (83.2%) mothers were from rural area. Most common presenting complaint was pain in abdomen (29.8%) followed by bleeding per vaginum in 16.8%. Only a small percentage i.e. 6.9% had no complaint. Hypertensive disorder of pregnancy (preeclampsia, eclampsia, chronic hypertension) was found to be an important comorbid factor among patients of IUFD which accounts for 31%. About 54.2% stillborn were males showing male preponderance. Post partum complications were relatively rare but most frequent was occurrence of severe anaemia due to APH. Maternal mortality occurred in 0.8% cases.

Conclusions: In conclusion, IUFD is closely associated with maternal health disorders and demo-socioeconomic factors are highlighting the need for improved antenatal care and management to mitigate risks.

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

2025-10-30T06:30:27+0530

Background: 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.

Study of the incidence of tubal ligation and long-acting reversible contraceptives in tertiary care centre: a population-based study

2025-10-30T06:30:24+0530

Background: Tubal ligation and long-acting reversible contraceptives (LARC) provide reliable long-term contraception; however, women’s choices are influenced by factors such as age, parity, previous deliveries, and counselling. This study aimed to assess and compare the acceptance of tubal ligation versus LARC among reproductive-aged women at a tertiary care centre, with the primary objective of identifying the demographic, obstetric, and socioeconomic factors affecting their choice of contraception.

Methods: A prospective cross-sectional study was conducted from April 2023 to December 2024 at a tertiary care obstetrics and gynecology centre. Sexually active women aged 19-49 years seeking post-partum family planning were recruited via purposive sampling if opting for tubal ligation or LARC. Sociodemographic, obstetric, and contraceptive data were collected and analysed using SPSS.

Results: Most participants were aged 26-32 years (79, 46.47%) and 18-25 years (75, 44.12%). FTND was the most common previous pregnancy (105, 61.76%). The uterus was anteverted in 165 (97.06%). Contraception choices included tubectomy (99, 58.23%), PPIUCD (28, 16.47%), and DMPA (34, 20%). LARC use was higher in P1L1 (28, 100%) and P1L1A2 (4, 100%), while tubectomy was associated with higher parity and previous LSCS (p<0.001). Delivery mode also influenced method (LSCS 37, 56.92%; FTND 62, 59.05%; p=0.0069).

Conclusions: Tubal ligation was the main contraceptive choice, especially among multiparous women and those with prior cesarean sections. LARC was preferred by younger or lower-parity women but remained underutilised. Choices were influenced by obstetric history and delivery mode, underscoring the need for better counselling, awareness, and access.

Cesarean section delivery at a tertiary care center

2025-10-30T06:30:24+0530

Background: With the better surgical techniques, better anesthesia and with use of prophylactic antibiotics, cesarean sections are now considered a relatively common and safe operative procedures. Cesarean section is carried out with an incision on anterior abdominal wall and delivery of fetus by laparotomy. There may be an unambiguous association between cesarean delivery and fetomaternal morbidity and mortality. Rising trend in cesarean section deliveries need to be analysed and its effect on fetomaternal outcome at tertiary care centers.

Methods: This retrospective study was carried out with the aim to study the trends in cesarean section deliveries over the period extending from March 2022 to March 2024 has included all cesarean section delivery cases fulfilling the inclusion and exclusion criteria. The data were collected from the medical record department (MRD) and was kept confidential, and privacy of the patients were maintained, and data was analysed as per predefined proforma.

Results: The cesarean section rate was 49.11% out of 2596 deliveries, out of which most common indication being previous CS (37.89%) followed by fetal distress (18.24%). Majority of cases belonged to Robson group 5 followed by group 2. Emergency CS 61.72%, some neonatal complications were seen in which major cause was respiratory distress (9.88%). No fetomaternal mortality occurred during the study period.

Conclusions: Although with advent technology and medical advancement cesarean section is being a much safer and better operative procedure but its impact on future pregnancies and morbidity related to it should be kept in mind. The audit regarding the rate, indications and complications related to cesareans section should be analysed in all health care facilities.

Evaluation of thyroid disorders in pregnancy: prevalence and its varieties

2025-10-30T06:30:22+0530

Background: 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.

A study on existing gaps in current antenatal care and new WHO model of routine antenatal care: need for implementation of new WHO guidelines on antenatal care

2025-10-30T06:30:20+0530

Background: Antenatal care is essential for ensuring good maternal and neonatal health outcomes, yet significant gaps remain in its delivery. In 2016, the WHO introduced new antenatal care guidelines increasing the number of antenatal contacts to 8, from the old 4 visit approach. The new model focuses on strengthening the connection between health care workers and pregnant women receiving antenatal care. However, utilization rate for the level of recommended antenatal care is still low especially in developing countries like India, thus further highlighting the need for identifying and bridging the gaps in antenatal care delivery. This study critically assessed the current challenges with antenatal care delivery by healthcare workers, aiming to identify gaps in existing practices and evaluate the need for implementing the New WHO antenatal care guidelines (2016).

Methods: A qualitative type of cross-sectional study was conducted at a tertiary care hospital in western Maharashtra, India among 128 mothers who were admitted to the post-natal ward of the hospital. Data collection was done using a pretested, prevalidated questionnaire, descriptive statistics were used to summarise the data.

Results: The study found that while 92% of women had recommended number of antenatal care contacts in the first and second trimester, while none had five antenatal care contacts in the third trimester. 50% of mothers had below recommended IFA consumption. Regarding nutritional counselling and non-pharmacological management of common pregnancy symptoms only 5.46% received guidance on nausea and 29.68% on heartburn management. All participants received respectful maternal care aligning with the WHO guidelines.

Conclusions: The findings demonstrate the need for active implementation of the new 2016 WHO’s guidelines on antenatal care to enhance the quantity and quality of antenatal care delivered. Ensuring that healthcare workers provide recommended education, immunization, supplementation, and maternal support throughout pregnancy. Identifying and bridging these gaps will help improve maternal and neonatal health outcomes, aligning practices with global standards and contributing to positive pregnancy experiences for pregnant women.

Comparison of radiological imaging techniques for placenta accreta spectrum to optimise feto-maternal outcome by antenatal detection and management plan at a tertiary care centre

2025-10-30T06:28:57+0530

Background: Placenta accreta spectrum remains one of the most dangerous obstetric conditions especially when antenatal suspicion amounts to nil, resulting in severe feto-maternal outcomes. Therefore, accurate and optimal prenatal imaging is mandatory to instigate necessary preparation and strategic management approach.

Methods: We conducted a prospective study in our tertiary care centre, Punjab in duration of 18 months enrolling 54 antenatal patients fulfilling the inclusion criteria, reporting to the labour room by non-probability convenient sampling technique. Patients were subjected to radiological imaging (both ultrasonography and MRI) which was then followed by surgery. The data was analysed using suitable statistical software.

Results: We observed that patients with previous history of some surgery, be it caesarean section or D and C, pose a greater threat of acquiring placenta accreta syndrome and may tend to cause preterm births. Thus, requisiting antenatal diagnosis with the intent to ameliorate feto-maternal outcomes.

Conclusions: MRI has better diagnostic accuracy in terms of sensitivity and overall accuracy than sonography. Although cost and accessibility may limit the use of MRI, both aid in prenatal assessment and multi-disciplinary approach to help improve maternal and fetal outcome.

Hypothyroidism and its influence on maternal and perinatal outcomes: insights from a hospital-based retrospective study

2025-10-30T06:28:55+0530

Background: Hypothyroidism during pregnancy is a prevalent endocrine disorder that significantly impacts maternal and perinatal health in the form of infertility, early pregnancy loss, PIH, anaemia, IUGR, PROM, preterm labour, neonatal mortality and morbidity. This retrospective hospital-based study aimed to evaluate the maternal and fetal outcomes associated with hypothyroidism in pregnant women.

Methods: Medical records of pregnant women diagnosed with hypothyroidism were reviewed to assess clinical characteristics, treatment status, and pregnancy outcomes. Maternal complications such as anaemia, preeclampsia, PPH, hypertension, miscarriage were recorded alongside perinatal outcomes including preterm birth, low birth weight, and intrauterine growth restriction. A total of 550 antenatal women with singleton pregnancies and without any pr-existing medical disorder were screened. All patients were monitored up to the point of delivery, allowing for comparison of outcomes across the three groups.

Results: Among the study cohort of 550 antenatal women, 70 were found to have hypothyroidism with an estimated prevalence of 12.72, largely comprising subclinical cases. A higher incidence of hypothyroidism was seen among multigravida patients. Lower segment cesarean section (LSCS) was the most common mode of delivery in the women with hypothyroidism. In addition, hypothyroid mothers experienced higher incidences of adverse outcomes such as preeclampsia, miscarriage, preterm labor, low birth weight infants, IUGR, foetal distress and need for NICU admission as compared to euthyroid mothers. Early identification and treatment with levothyroxine were associated with improved maternal and fetal outcomes.

Conclusions: Hypothyroidism in pregnancy is associated with significant risks for both mother and child. Routine screening and timely treatment are critical measures to mitigate these risks and improve pregnancy outcomes. The findings highlight the necessity of universal thyroid function screening protocols in antenatal care to ensure optimal maternal and perinatal health.

A study of maternal near miss cases at tertiary care centre, Rajkot

2025-10-30T06:28:54+0530

Background: A maternal death is one of the most serious complications in obstetrics, with major impact on family members and staff involved. For every woman who dies from pregnancy or childbirth-related causes, it is estimated that twenty more suffer from pregnancy-related illness or experience other severe complications, these are considered as near-miss cases. The aim is to study the prevalence and clinical profile of maternal near miss in a tertiary care centre and assess the underlying socio-demographic variables, complications and contributing factors among near miss cases.

Methods: A hospital based prospective observational study was carried out at department of obstetrics and gynaecology at P.D.U medical college and hospital, Rajkot for the period of 18 months. The study population were the patients admitted in the department of obstetrics and gynaecology at P.D.U medical college and hospital, Rajkot. Selection of patients was according to WHO near miss criteria published in 2011. Demographic details, obstetric history along with past medical and surgical history were the main components in patient interview.

Results: 12916 live births occurred during the study period. Maternal near miss incidence was 15.79 per 1000 live births; Maternal near miss to mortality ratio was 4.34; Severe maternal outcome ratio was 19.43 per 1000 live births. Anaemia followed by hypertensive disorders in pregnancy were most common disorders seen in our study.

Conclusions: In order to decrease maternal mortality, awareness among general public, timely antenatal visits and early detection of complication and timely management is required.

Association of maternal neutrophil-lymphocyte ratio with adverse perinatal outcomes in preterm premature rupture of membranes: a case-control study

2025-10-30T06:28:54+0530

Background: Preterm premature rupture of membranes (PPROM) is a significant contributor to preterm birth and is associated with both maternal and perinatal complications. Neutrophil lymphocyte ratio (NLR) is an emerging marker of systemic inflammation. This study was conducted to evaluate the association of maternal NLR with adverse maternal and perinatal outcomes in PPROM cases.

Methods: This prospective case-control study was conducted among 60 pregnant women (30 PPROM cases with elevated NLR and 30 controls with normal NLR). Maternal NLR was calculated using complete blood count reports. Participants were grouped based on NLR levels and their association with maternal and perinatal outcomes were study.

Results: The incidence of neonatal intensive care unit (NICU) admission was significantly higher among newborns in the case group (70%) compared to the control group (36.66%). Similarly, perinatal mortality was markedly elevated in the case group (70%) relative to the control group (13.33%), indicating an overall poorer perinatal outcome in the case group.

Conclusion: Elevated maternal NLR is significantly associated with adverse maternal and perinatal outcomes in PPROM. It can serve as a simple and cost-effective inflammatory marker for risk stratification and early intervention.

Leptin and LH/FSH ratio as independent predictors of polycystic ovary syndrome in normoglycemic women: a case-control study

2025-10-30T06:27:38+0530

Background: Polycystic ovary syndrome (PCOS) is a multifaceted disorder characterized by reproductive, metabolic, and endocrine disturbances. While insulin resistance (IR) is recognized as a central feature, the interplay of adipokines, lipid metabolism, gonadotropin imbalance, and inflammation in normoglycemic PCOS women remains underexplored.

Methods: A case-control study was conducted on 30 newly diagnosed normoglycemic women with PCOS (Rotterdam criteria, 2003) and 30 age-matched healthy controls. Anthropometric, hormonal (LH, FSH, LH/FSH ratio, prolactin, estrogen, progesterone, testosterone), metabolic (fasting glucose, HbA1c, insulin, HOMA-IR), lipid (cholesterol, triglycerides, HDL), adipokine (leptin), and hematological parameters were assessed. Group comparisons were performed using independent t-test/Mann-Whitney test as appropriate. Correlation analysis explored inter-relationships among variables, and multivariate logistic regression identified independent predictors of PCOS.

Results: Compared with controls, PCOS women had significantly higher BMI (26.3±5.3 versus 23.4±3.2 kg/m²; p=0.014), WHR (0.861±0.061 versus 0.799 ±0.060; p<0.001), LH (7.5±3.7 versus 5.3±2.2 mIU/ml; p=0.006), LH/FSH ratio (1.37±0.76 versus 0.76±0.32; p<0.001), estrogen (54.5±18.2 versus 38.0±11.1 pg/ml; p<0.001), testosterone (49.7±25.1 versus 34.5±14.0 ng/dl; p=0.001), fasting insulin (11.55±10.8 versus 5.63±2.6 uIU/ml; p=0.004), HOMA-IR (2.47±2.4 versus 1.17±0.54; p=0.007), and leptin (31.3±17.4 versus 16.4±10.5 ng/ml; p<0.001), with significantly lower FSH (5.6±1.7 versus 7.2±1.9 mIU/ml; p<0.001) and HDL (43.0±10.0 versus 54.3±15.3 mg/dl; p<0.001). Correlation analysis revealed positive associations between BMI and leptin, insulin, and HOMA-IR; WHR and testosterone; TLC and leptin/WHR; and LH/FSH ratio and estrogen, while HDL correlated negatively with HOMA-IR and TLC. Logistic regression identified leptin (OR=1.105, 95% CI 1.016-1.201, p=0.020) and LH/FSH ratio (OR=18.48, 95% CI 1.82-187.7, p=0.014) as independent predictors of PCOS.

Conclusions: Normoglycemic PCOS women show distinct hormonal, metabolic, and adipokine alterations, with leptin and LH/FSH emerging as robust independent predictors. These findings highlight the early convergence of adiposity, insulin resistance, inflammation, and gonadotropin imbalance in PCOS, underscoring the need for early biomarker-based risk stratification and intervention even before the onset of overt glycemic abnormalities.

Assessment and comparison of clinical scar tenderness and imaging scar thickness for prediction of intraoperative scar integrity in pregnant patients with previous caesarean section

2025-10-30T06:27:37+0530

Background: Caesarean delivery rates have significantly risen over the past few decades, leading to an increase in the number of women with previous caesarean scars. In subsequent pregnancies, the integrity of uterine scar becomes an essential factor in decision making regarding the mode of delivery. Accurate assessment of scar integrity enables obstetricians to predict and mitigate the risks associated with vaginal birth after caesarean delivery. Several studies have independently demonstrated the reliability of scar tenderness and scar thickness in assessing uterine scar integrity; however, this study compares both these parameters for better prediction of the intraoperative scar integrity.

Methods: 100 patients with history of previous LSCS were assessed for scar tenderness and third trimester’s sonographic LUS scar thickness and later on were taken up for caesarean section. Findings were correlated with intra-operative scar condition, whether the scar was intact or was compromised (scar dehiscence or rupture).

Results: Scar thickness <2.5 mm demonstrated a sensitivity of 50%, specificity of 85%, positive predictive value of 60%, negative predictive value of 80%. Scar tenderness alone showed sensitivity of 66% and specificity of 71%, PPV of 60% and NPV of 82%. However, when both parameters were considered as combined criteria, the sensitivity improved to 74% and specificity increased to 96%, a higher PPV of 93% and an NPV of 86%.

Conclusions: Combined assessment of clinical and sonographic parameters provides a more reliable method for identifying women at risk of uterine scar compromise during subsequent deliveries.

Awareness and preventive practices for anaemia among urban school going adolescent girls

2025-10-30T06:27:33+0530

Background: Anaemia is a significant public health concern in India, particularly among adolescent girls. The objective was to assess awareness and dietary practices related to anaemia among urban adolescent school-going girls and indirectly evaluate the effectiveness of the weekly iron and folic acid supplementation WIFS Program.

Methods: A prospective questionnaire-based survey was conducted among urban adolescent school-going girls in India. The data so obtained was analysed.

Results: High awareness levels regarding anaemia were observed (98.9%). Additionally, 96.7% of the respondents were aware that anaemia was a health problem, 71.3% of respondents could satisfactorily talk about anaemia, and 28.7% had insufficient knowledge. Awareness about anaemia symptoms was lower, with only 56.2% giving satisfactory responses. Most girls adopted good practices to prevent anaemia. 85.7% took iron supplements, which the government provides under the WIFAS scheme, and 78.7% consumed green leafy vegetables. The hygiene practices are well maintained, with 98.9% washing hands before meals and 100% washing hands after defecation. 85.6% had taken deworming tablets, which helped in preventing anaemia caused by parasitic infections 60.3% reported experiencing stress or worry, which may indirectly affect anaemia management, as stress can impact nutritional intake and overall health.

Conclusion: Targeted educational initiatives are necessary to enhance knowledge about anaemia symptoms and promote consistent dietary habits. Continuous monitoring and supportive health interventions are crucial to ensure better anaemia prevention and management.

Maternal near miss: as a tool for improving obstetric care: a 4.5-year audit from a tertiary referral centre in Sikkim

2025-10-30T06:27:32+0530

Background: Maternal near-miss (MNM) audits are valuable tools for evaluating obstetric care and identifying gaps in the health system. Limited data are available from Sikkim, where a single tertiary centre caters to all six districts. This study aimed to assess the incidence of maternal near-miss and maternal mortality over a four and a half year period, and to implement the results for better maternal health.

Methods: A retrospective observational study was conducted at a tertiary referral hospital in Sikkim, reviewing all deliveries between [2021-2025]. Maternal near-miss cases were identified. Indicators including MNM incidence ratio (NMIR), MNM to mortality ratio (MNM:MD), mortality index, and maternal mortality ratio (MMR) were calculated.

Results: A total of 5,401 deliveries and 5,330 live births were recorded. There were 44 maternal near-miss cases and 8 maternal deaths. The NMIR was 8.25 per 1,000 live births, MNM:MD ratio was 5.5, and the mortality index was 15.4%. The calculated MMR was 150 per 100,000 live births. Compared to national figures (MMR ~93 per 100,000; NMIR ranging 3-17/1,000), the centre recorded a higher MMR and a moderate NMIR.

Conclusions: The elevated MMR reflects referral nature of the institution, with most women presenting in moribund condition. The relatively lower NMIR suggests possible early recognition and prevention, but high mortality index underscores need for strengthening critical care, timely referral, and district-level facilities. Focused improvements in emergency obstetric management and referral systems are essential to reduce maternal morbidity and mortality.

Does the oocyte quality impact intracytoplasmic sperm injection outcomes in severe male factor infertility: a retrospective study

2025-10-30T06:27:30+0530

Background: ICSI has transformed the approach in treating severe male factor infertility, however the quality of oocyte plays a significant role in compensating for sperm abnormalities and enhancing the clinical outcomes. The study aims to evaluate the impact of oocyte quality on fertilization rates, embryo development and pregnancy outcomes in couples undergoing intracytoplasmic sperm injection (ICSI) in two distinct groups- cryptozoospermia and azoospermia.

Methods: A retrospective observational study was conducted at a fertility centre in a tertiary hospital. A total of 61 couples with male infertility were included in the study. Group 1 includes 42 patients diagnosed with cryptozoospermia and Group 2 includes 19 patients diagnosed with azoospermia. Controlled ovarian stimulation was done using gonadotrophins to induce follicular development followed by ICSI procedure. All the retrieved oocytes were categorized based on the morphology criteria outlined in the Istanbul consensus into two distinct groups: oocytes with normal morphology and oocytes with abnormal morphology. Clinical outcomes including fertilization rate, implantation rate, pregnancy rate and miscarriage rate were evaluated.

Results: The observed fertilization rate in oocytes with normal morphology and oocytes with abnormal morphology was 84.03% vs. 78.26% in the cryptozoospermia group and 80.76% vs. 78.57% in the azoospermia group. The overall pregnancy rate was 26.19% in group 1 and 31.58% in group 2 with no statistical significance. Oocytes with normal morphology exhibited higher pregnancy rates, while oocytes with abnormal morphology showed very low or no pregnancy in both groups.

Conclusions: The study concludes oocyte quality has a greater impact on the ICSI outcomes irrespective of the type of sperm used. Future studies with a large cohort size are needed to validate these findings.

Impact of cigarette smoking on semen quality and sperm DNA fragmentation in infertile men of Chhattisgarh, India

2025-10-30T06:27:29+0530

Background: Cigarette smoking is a major risk factor for male infertility, primarily by reducing sperm count and motility, thereby impairing spermatogenesis and overall reproductive function. This study aimed to evaluate the effects of smoking on semen parameters and sperm DNA integrity in infertile men.

Methods: A total of 200 male partners of infertile couples attending an infertility clinic in Raipur, Chhattisgarh, from 2022 to 2024 were included. Detailed smoking histories were obtained, followed by semen analysis. Statistical comparisons between smokers and non-smokers were performed using appropriate software.

Results: Smokers had significantly lower semen volume (2.08±0.78 versus 2.45±0.79 ml), total sperm count (59.22±60.39 versus 94.12±91.12 million), total motility (44.82±24.66 versus 57.03±20.33%), progressive motility (24.67±24.19 versus 33.07±24.14%), vitality (46.46±20.18 versus 56.81±22.15%), and normal morphology (3.25±1.27 versus 3.84±1.42%), with higher DNA fragmentation index (21.33±10.52 versus 15.05±6.63%) compared with non-smokers. Moderate or occasional smokers exhibited intermediate values. Sperm concentration did not differ significantly. Normozoospermia was most frequent in non-smokers (46%), whereas daily smokers showed higher prevalence of asthenozoospermia, teratozoospermia, and combined abnormalities, suggesting a dose-dependent negative effect of smoking.

Conclusion: Cigarette smoking significantly impairs semen quality and increases sperm DNA fragmentation, contributing to male infertility. Even intermittent smoking adversely affects semen parameters, highlighting the importance of smoking cessation for fertility preservation.

Maternal and fetal outcomes in pregnancies complicated by renal disease: a single-centre observational study

2025-10-30T06:27:25+0530

Background: Renal disease in pregnancy poses significant risks for both mother and fetus, with increased rates of maternal morbidity, fetal growth restriction, preterm delivery, and adverse neonatal outcomes. In India, women comprise nearly half the renal disease burden, and 3-5% of them conceive. This study evaluates the clinical profile, maternal, and fetal outcomes of pregnancies complicated by renal disease.

Methods: A retrospective observational study was conducted at a tertiary care hospital in Western India between February 2020 and July 2023. All pregnant women with documented renal disease or renal abnormalities were included. Data on demographics, comorbidities, renal parameters, obstetric outcomes, and complications were analysed.
Results: Of 44 screened women, 36 met inclusion criteria. Mean age was 29.2±4.7 years; 58.3% were multigravida. Hypertension (27.8%) and proteinuria >1000 mg/day (16.7%) were significant predictors of adverse fetal outcome (p<0.05). Maternal age >30 years and multigravida status were significantly associated with caesarean delivery (p<0.05). Preterm delivery occurred in 41.7%, and intrauterine growth restriction in 25%.

Conclusions: Pregnancies complicated by renal disease represent a high-risk group requiring multidisciplinary management. Preconception counselling, optimal blood pressure control, and close antenatal surveillance can improve outcomes. Larger multicentric studies are needed for more definitive guidance.