https://www.ijrcog.org/index.php/ijrcog/issue/feed International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-04-26T20:02:00+0530 Editor medipeditor@gmail.com Open Journal Systems <p>International Journal of Reproduction, Contraception, Obstetrics and Gynecology (IJRCOG) is an open access, international, peer-reviewed journal. The journal's full text is available online at https://www.ijrcog.org. The journal allows free access to its contents. IJRCOG publishes original research work in all relevant areas of reproduction, contraception, obstetrics and gynecology that include reproductive endocrinology, reproductive physiology, assisted reproductive technologies, cloning, environmental effects on reproductive health, infertility, family planning, sexual health, obstetrics, prenatal diagnosis, materno-fetal medicine, midwifery, perinatology, gynecological urology, gynecological oncology, gynecological endocrinology, general gynecology and menopause. International Journal of Reproduction, Contraception, Obstetrics and Gynecology (IJRCOG) provides a platform for fast communication to scientists and clinical professionals in the fields of obstetrics and gynecology throughout the world. The types of articles accepted include original research articles, review articles, case reports, conference abstracts, medical news, new drug updates, short communications, correspondence, images in medical practice, clinical problem solving, perspectives and letters to the editor. It is published <strong>monthly</strong> and available in print and online version. International Journal of Reproduction, Contraception, Obstetrics and Gynecology (IJRCOG) complies with the uniform requirements for manuscripts submitted to biomedical journals, issued by the International Committee for Medical Journal Editors.</p> <p><strong>Issues: 12 per year</strong></p> <p><strong>Email:</strong> <a href="mailto:medipeditor@gmail.com" target="_blank" rel="noopener">medipeditor@gmail.com</a>, <a href="mailto:editor@ijrcog.org" target="_blank" rel="noopener">editor@ijrcog.org</a></p> <p><strong>Print ISSN:</strong> 2320-1770</p> <p><strong>Online ISSN:</strong> 2320-1789</p> <p><strong>Publisher:</strong> <a href="http://www.medipacademy.com/" target="_blank" rel="noopener"><strong>Medip Academy</strong></a></p> <p><strong>DOI prefix:</strong> 10.18203</p> <p>Medip Academy is a member of Publishers International Linking Association, Inc. 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This included studies evaluating RAL in general gynecology, urogynecology, and gynecological oncology. RAL has emerged as a transformative technology, demonstrating efficacy in procedures ranging from routine gynecologic tasks to complex oncological surgeries. The adoption of RAL has facilitated improved surgical outcomes, reduced learning curves, and enhanced visualization. Superior dexterity, 3D vision, and filtered tremor contribute to its precision. The ergonomic advantages, including intuitive instrument movements and a third assisting arm, further enhance positive outcomes. Notably, RAL has shown promise in managing challenging patient demographics, such as morbidly obese individuals and those with intricate pelvic anatomy. In gynecological oncology, RAL has become integral, manifesting benefits in endometrial, cervical, and ovarian cancer surgeries. Despite challenges like cost considerations, RAL continues to shape the landscape of gynecological surgery, promising improved patient outcomes and contributing to the paradigm shift toward minimally invasive approaches. Ongoing research should focus on long-term cost-effectiveness, patient perspectives, and attitudes toward RAL, ensuring its continued integration into the evolving field of gynecological surgery.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14005 Female sexual dysfunction: a review 2024-03-06T10:50:31+0530 Asmita Kaundal drasmita_kaundal@yahoo.com Prachi Renjhen renjhen@gmail.com <p>Sexual health is an important aspect of human life and to maintain a healthy and happy sexual life a positive integration of physical, social as well and psychological domains is very important. Any alteration in any of these domains can lead to sexual dysfunction which can significantly affect the quality of life of a couple. Many couples live with the problem and suffer silently due to shyness, stigmas, and social norms related to the issue. Many times even the treating medical professionals also do not screen for the sexual issues due to inadequate knowledge and training related to sexual dysfunction further increasing the burden of the disorder which remain undiagnosed. Sexual dysfunction can affect both men and women. Since the sexual cycle is complex in women both diagnosing and treating the female sexual dysfunction can often be challenging. Routine screening, meticulous workup and multidisciplinary approach is usually required to diagnose and mange sexual disorders.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13991 Labia minora necrosis secondary to bilateral Bartholin cyst resection: a case report 2024-03-02T00:26:57+0530 Karla Durán Moreno k.duran92@hotmail.com Filiberto Martínez Cabrales filibertomartinez@hotmail.com Luisa Fernanda Rivas Penilla luisarivas87@gmail.com <p>This is a case report of a necrosis of labia minora secondary to bilateral Bartholin cyst resection. A 48-year-old woman with history of bilateral Bartholin cyst resection in the previous month, she presented a discontinuity of the right labia minora in its upper segment of 2x3 cm, she reported no pain or discomfort, no dyspareunia. A labiaplasty with edge resection technique was performed there were no signs of hematoma or any complications in the procedure. In a 3 month follow up we observed a resolution of necrosis, no dyspareunia and had adequate aesthetic results. This is a rare complication in large Bartholin gland cysts, there is scarce literature about it and there is no evidence as to which labiaplasty technique is superior in the case of this complication. We present an option of treatment in a labia minora necrosis due to a surgical complication.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13987 The effect of hypokalemia in pregnancy on fetal heart rate 2024-03-01T17:27:36+0530 Febriani febriani@lecturer.unri.ac.id Riki Nofiandi rikinofiandi@gmail.com <p>Hypokalemic myopathy can cause anything from weakness and numbness to total paralysis. The cause could be acquired or congenital. It is distinguished by low potassium levels (&lt;3.5 meq/L) and severe muscle weakness. We present a case of 30-year-old multigravida at 31 weeks of gestation with malnourished condition, who came with acute onset of weakness of both legs. She was diagnosed to have hypokalemic paralysis with potassium levels of 1.5 meq/L. The medical profile remitted promptly on intravenous potassium replacement. Pregnancy was continued till 37 weeks with oral potassium supplements and regular monitoring of serum potassium levels.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14018 Sertoli-Leydig tumor in a 17-year-old girl: a case report 2024-03-12T05:41:27+0530 Fridjof S. G. Robergeau fryshmartin@gmail.com Larry M. Massena massenalarry27@gmail.com Maky-Kenson Nazaire nazairemaky@gmail.com Bernard Gilles gillesbernar91@gmail.com Christophe Millien milchristophe@gmail.com <p>Sertoli-Leydig tumors of the ovary are rare. They can affect women in all age groups but are more frequent in the first three decades. No case of Sertoli-Leydig cells tumors has been reported in the Haitian literature. We present a case of a 17-year-old teenage who was seen in the outpatient clinic of the Mirebalais teaching hospital for: amenorrhea, change in voice and hair loss. After our evaluation and the completion of certain assessments, the clinical impression of a stromal and sexual cord tumor was retained, which guided us to perform a laparotomy. We conclude that in the management of this type of case, it is important to take into account the desire to preserve the patient's subsequent fertility and if there is one point that should not be overlooked, it is the psychosocial repercussions of the pathology before and after its treatment.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14047 Open surgical retrieval of ovarian migrated intrauterine contraceptive device: a case report 2024-03-22T01:41:41+0530 Temidayo I. Bobo temidayo2712@gmail.com Adetomilola K. Popoola tomight4real2007@gmail.com Gloria A. Duke-Aluko temidayo2712@gmail.com Gbemi H. Ano-Edward temidayo2712@gmail.com Tola Y. Bakare temidayo2712@gmail.com <p>Intraovarian migration of intrauterine contraceptive device (IUD) is a rare complication, only few cases have been reported. Arguably no reported case in Nigeria to best of knowledge. The patient was Mrs. S.I, a 29-year-old primiparous presented with a 6-hour history of abdominal pain, the pain was said to be sudden in onset pain associated with vomiting. She used an IUD for contraception for about 2 years prior to her presentation. The physical examination showed a patient with good hemodynamic and ventilatory status. Abdominal and vaginal examination revealed marked tenderness at suprapubic and left iliac region, with positive cervical excitation and left adnexal tenderness respectively. Provisional diagnosis of acute pelvic inflammatory disease was made, empirical broad spectrum antibiotic therapy commenced, pelvic scanning done revealed a hyperechoic structure, likely intrauterine device, perforating the uterine fundus and extending into the left ovary. Subsequently, she had laparotomy and the removal of the device. She did well post-surgery and was discharged home to follow in the clinic on the third day after surgery. Intraovarian migration of IUD is one of the rare complications of the device. High index of suspicion with radiological imaging support is necessary in making the diagnosis in a woman of reproductive age group with IUD in- situ regardless of the visible IUD string or not.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13700 Laparoscopic resection of functional non communicating rudimentary horn of uterus in adolescent girl 2024-02-23T20:53:19+0530 Ramita Aggarwal aggarwalramita@gmail.com Jagpreet Kaur jagpreetkaurbrar@gmail.com Monika Gupta aggarwalramita@gmail.com <p>Unicornuate uterus with rudimentary horn is a rare type of mullerian anomaly associated with many obstetrical and gynaecological complications. The incidence is approximately 1:100000. Author reports a case of 18-year-old unmarried female with unicornuate uterus with non-communicating and functional rudimentary horn presented with chief complaint of refractory dysmenorrhea.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13777 Pregnancy with severe hypertrophic obstructive cardio myopathy fighting against all odds: a case report 2023-12-16T18:17:38+0530 Kalyani Sai Dhandapani drkalyanis@yahoo.co.in Anushri Manimaran drkalyanis@yahoo.co.in Hajira Fathima drkalyanis@yahoo.co.in <p>Hypertrophic obstructive cardiomyopathy (HOCM) is an inherited condition causing left ventricular outflow tract (LVOT) obstruction, with a prevalence of 1 in 500. Widespread use of echocardiography has led to this disorder being increasingly diagnosed in pregnant women. Knowledge of HOCM is imperative for obstetricians. Pregnancy is generally well tolerated in HOCM but women who are symptomatic pre pregnancy or have significant LVOT obstruction can develop complications such as heart failure, arrhythmias and sudden cardiac death.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13840 Unruptured tubal ectopic pregnancy with very high levels of beta HCG: a rare case report 2024-01-12T22:34:57+0530 Shantanu H. Rajmane rajmaneshantanu@gmail.com Sunita M. Ubale rajmaneshantanu@gmail.com Mamta N. Anand rajmaneshantanu@gmail.com J. B. Senapati rajmaneshantanu@gmail.com <p>When the fertilized ovum is implanted outside the endometrial cavity, it is termed as ectopic pregnancy. The most common site being fallopian tube. The commonest site to be affected is ampulla of the fallopian tube followed by isthmus. Fimbrial and interstitial are rare sites for ectopic pregnancy. The incidence of ectopic pregnancy is increased over couple of decades. Important causes include PID, previous history of ectopic pregnancy, h/o tubal reconstructive surgery, h/o artificial reproductive techniques like IVF, use of IUD’s, h/o of tubal ligation etc. Fallopian tubal ectopic usually ruptures at duration of 7-8 weeks gestation. A ruptured tubal ectopic pregnancy can lead to massive haemorrhage leading to tachycardia, hypotension endangering life, which requires emergency surgical intervention &amp; transfusion blood and blood products. Ectopic pregnancy with beta HCG &lt;5000 IU/L, Gestational sac &lt;4 cm, &amp; vitally stable, can be managed medically with methotrexate, whereas higher levels of beta HCG, Gestational sac &gt; 4 cm with live ectopic pregnancy and vitally unstable becomes obstetric emergency which should be managed surgically. Thorough clinical examination, use of ultrasonography and beta HCG levels, helps in timely diagnosis and management of ectopic pregnancy which can be lifesaving. This is a rare case report of unruptured live fimbrial ectopic pregnancy with very high levels of beta HCG (&gt;50,000 mIU/ml), which was managed surgically.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13979 De novo late postpartum preeclampsia: a case report with review of literature 2024-02-28T19:11:14+0530 Basanta Manjari Hota drmanjarihota@gmail.com N. S. Sai Anusha nssanushaw@gmail.com Guguloth Sneha Snehaguggu05@gmail.com Yallamandala Devisri devisriyallamandala@gmail.com <p>De Novo late postpartum preeclampsia is defined by many authors as new onset postpartum hypertension of ≥140/90 mmHg with features of organ system malfunctioning during 48 hours to six weeks of delivery following a normotensive pregnancy and labor. Though a lesser studied condition it is responsible for more number and increased severity of maternal morbidity, mortality, and cause of post-delivery hospital admission. Its exact cause is not yet clearly defined. The incidence is 0.3-27% as noted by many authors. Patients usually present on day 7-10 with severe headaches, neurological symptoms like visual disturbances; symptoms of other organ involvement, and high blood pressure. High suspicion leads to diagnosis. Primary investigations include that for preeclampsia. The principle of management is the reduction of blood pressure, prophylactic anticonvulsants, and diuretic is considered if there are features of fluid overload. She needs constant monitoring. Post delivery women, after discharge, do not avail of home blood pressure monitoring and even the symptoms, to start with are treated with over-the-counter medication. This leads to worsening of the condition. Our patient, a primipara reported to this hospital on the 38<sup>th</sup> day of normal vaginal delivery following a normotensive pregnancy and delivery, with features of preeclampsia. The aim of publishing this case is for statistical records and create awareness of the condition. Every postpartum woman on discharge from the hospital following a normotensive pregnancy and delivery must be counseled on the significance of home BP monitoring and must consult an obstetrician on developing any new symptoms.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13983 Abdomen-still a pandora’s box 2024-02-29T18:03:15+0530 L. Thulasi Devi mowgli1974.mt@gmail.com Adil Abdul Kalam dradilkalam@gmail.com <p>An interesting case of young lady who had undergone obstetric hysterectomy during delivery with left ovary <em>in situ</em>. She was taken up for laparoscopic oopherectomy at a later date for a large ovarian mass on left side which was removed. She presented to us with recurrence of pelvic mass. Preoperatively we were reminded of the adage and popular saying.” Abdomen-still a pandora’s box.” This article attempts to present the importance of truthful case notes in failed surgeries and effective communication to the patient to prevent clinical and surgical misadventures and dilemmas.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13997 Successful outcomes of a monoamniotic twin pregnancy discordant for anencephaly 2024-03-04T10:33:21+0530 Sujata Swain drsujata74@gmail.com Paresh Kumar Jena drsujata74@gmail.com <p>Mono amniotic twin pregnancy discordant for anencephaly (MATDA) is a rare occurrence. 29-year-old primi gravida was diagnosed with mono amniotic twin one baby anencephaly and other baby normal at 14 weeks of gestation during NT scan. Patient was counselled regarding selective termination &amp; expectant management outcomes. They wanted to continue the pregnancy with expectant management. She developed pregnancy induced hypertension around 30 weeks which was managed by oral labetolol. Caesarean section was performed at 36 weeks of gestation, with first baby normal &amp; second baby Anencephaly. The normal newborn infant was discharged from SNCU without any complications. Expectant management of a mono amniotic twin gestation discordant for anencephaly diagnosed at the first trimester is associated with a favourable outcome for the unaffected foetus.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14004 Exploring neuroendocrine carcinoma of the cervix: a case report and literature review 2024-03-06T01:48:11+0530 Sumedha Gupta sumedhagupta91@gmail.com Dheer Singh Kalwaniya Drdsk85@gmail.com Varsha Motwani dschoudhary@gmail.com <p>Neuroendocrine neoplasms (NENs) are rare, comprising less than 1% of cervical malignancies. Diagnosis and management of cervical neuroendocrine carcinoma (NEC) pose challenges due to its rarity and aggressive nature. Aim of the study was to highlight the importance of considering NEC in the differential diagnosis of cervical malignancies and underscore the potential benefits of comprehensive treatment approaches. We report a case of a 35-year-old woman presenting with post-coital bleeding, subsequently evaluated and diagnosed with NEC T1b1N0Mx following radical hysterectomy. Adjuvant chemoradiotherapy and chemotherapy led to one year of remission. Cervical NEC poses diagnostic and therapeutic challenges due to its rarity and aggressive nature. Despite multimodal treatment, prognosis remains poor, warranting further research and targeted therapies. The rarity of cervical NEC emphasizes the need for increased awareness among clinicians to facilitate early detection and appropriate management. Further studies are warranted to explore novel treatment modalities and improve outcomes for patients with this challenging malignancy.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14011 A rare case report on complications in pregnancy with systemic lupus erythematosus in a post-renal transplant patient 2024-03-10T23:51:54+0530 Niranjan N. Chavan nnchavan22@gmail.com Darshana P. Ajmera dpajmera28@gmail.com Deepali S. Kapote drdeepalikapote@gmail.com Prasad Y. Deshmukh drpydeshmukh@gmail.com Zubin N. Sheriar zubinsheriar@gmail.com Zeba Haroon Pathan drzebapathan1494@gmail.com Manan M. Boob mananboob2296@gmail.com <p>To preview the feto-maternal outcome in post-renal transplant pregnant women with systemic lupus erythematosus (SLE). To distinguish preeclampsia from hypertension in renal transplant recipients as diagnosis is not always straightforward and all differentials need a thorough evaluation. Hypertension is a prevalent issue among kidney transplant recipients, with reported incidence rates ranging from 52% to 69%. Additionally, the occurrence of pre-eclampsia in renal transplant recipients falls within the range of 24% to 38%, demonstrating a significantly elevated risk compared to the 4-5% incidence rate seen in the general population. A 29-year-old female para 1 IUFD 1 abortion 1, in a known case of SLE with hypothyroidism with lupus nephritis with post renal transplant status with thrombocytopenia with preeclampsia with day 7 of emergency LSCS done in view of non-progress of labor with intrauterine fetal demise with abruptio placenta referred in view of query SLE flare or severe preeclamptic features with rectus sheath hematoma. Renal transplant restores fertility; thus, pregnancy requires careful planning and affected women should be managed in tertiary care obstetrics centers working in tight multidisciplinary cooperation with transplant physicians.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14024 A case report on caesarean myomectomy 2024-03-14T14:56:32+0530 Shalini Mishra shalini.shalu15@ymail.com Namrata Sinha nims2k2@gmail.com Anima Prasad prasad_amrish@yahoo.com Amrish Kumar prasad_amrish@yahoo.com <p>Routine myomectomy at the time of caesarean section has been condemned in the past due to fear of uncontrolled haemorrhage and peripartum hysterectomy. It is still a topic of debate worldwide. However, in recent years, many case studies of caesarean myomectomy have been published validating its safety without any significant complications like excessive blood loss. We describe the case of a 23-year-old nulliparous women at 38 weeks of pregnancy with history of previous abortion. Her ultrasound was suggestive of singleton live intrauterine pregnancy with multiple intramurals and subserosal uterine fibroids seen in fundus, body region, posterior and anterior myometrium with largest fibroid of size 9×6.1 cm. The patient was taken up for elective caesarean section along with caesarean myomectomy. Live baby was delivered and successful myomectomy was done. Prophylactically oxytocin drip was given and intra myometrial carboprost was given to avoid blood loss. Patient was discharged on post-operative day 12 without any complications. Routine myomectomy at the time of caesarean section is not a standard procedure. However, it may be considered a safe option in carefully selected cases in the hands of an experienced obstetrician.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14056 A rare presentation of caesarean scar pregnancy: a case report 2024-03-25T14:43:03+0530 Harpoonam Manku harpoonam@gmail.com B. Nivetha nivethabalagopalan@gmai.com Jyothi apjyothiswarn19@gmai.com <p>Caesarean scar pregnancy (CSP) or retained products of conception is a rare but life-threatening complication. It is an abnormal implantation of the gestational sac or retained products of conception into the myometrium and a fibrous scar after a previous caesarean section. The incidence of such cases is on the rise due to the increase in caesarean sections worldwide. A 37-year-old P<sub>2</sub>L<sub>2</sub>A<sub>1</sub> (two previous caesarean sections and one spontaneous abortion followed by dilation and curettage) presented with complaints of vaginal bleeding and lower abdominal pain. She was diagnosed as a case of CSP with retained products of conception by ultrasonography and confirmation of the diagnosis was done by magnetic resonance imaging. An exploratory laparotomy was performed and the patient was successfully managed. Treatment must be individualized depending on the patient's hemodynamic profile, size, extent, depth, and vascularity, caesarean pregnancy, future fertility wishes, and compliance for follow-up.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14022 Use of Panicker’s cannula in management of atonic postpartum hemorrhage 2024-03-14T11:50:57+0530 Vaidehi Rana ranavaidehi9@gmail.com Alpesh Patel ranavaidehi9@gmail.com Vipul Patel ranavaidehi9@gmail.com <p>Postpartum hemorrhage (PPH) is leading cause of maternal mortality worldwide. Panicker’s cannula creates negative pressure inside the uterus that causes shrinking of the uterus which can assist the physiological process of contraction and retraction to stop atonic postpartum hemorrhage. It is safe and simple technique to prevent and treat PPH. It can be used in low-resource and primary care settings, where even para medical personnel can use this method effectively to prevent morbidity and mortality. This can also be used in non-PPH conditions. In this study total 20 women with singleton pregnancy (14 had vaginal delivery and 6 underwent cesarean section), who developed atonic postpartum hemorrhage were included in the study. Panicker’s cannula was used in the patients, in whom bleeding was not stopped despite using uterotonics. Cessation of complete bleeding was observed in all 20 women within 4 minutes, which was associated with contraction and firm retraction of the uterus. Amount of the blood in bottle ranged from 150-250 ml. Vacuum retraction of uterus assists in the normal physiological process of contraction and retraction. This simple and cost effective technique, takes very little time to stop bleeding. This lifesaving technique is useful in all settings especially in low resource settings.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14019 Insights into neoadjuvant chemotherapy efficacy for stage 1B3 locally advanced cervical cancer: case series 2024-03-12T13:22:59+0530 Sumedha Gupta sumedhagupta91@gmail.com Ratika Gupta ratika_225@gmail.com Saritha Shamsunder shamsundersarita@gmail.com <p>Cervical cancer remains a leading cause of mortality among women worldwide, particularly in developing nations. While radical surgery is the established standard of care for early-stage disease, pelvic relapse post-surgery remains a concern. Neoadjuvant chemotherapy (NACT) preceding radical surgery has emerged as a promising approach, aiming to reduce tumor burden and improve surgical outcomes. We present three cases of stage 1B3 cervical cancer treated with three cycles of NACT repeated three weekly followed by radical hysterectomy. Post-operatively two patients received radiotherapy (External beam radiotherapy and brachytherapy) and one patient got lost to follow-up for 6 months and did not receive post-operative radiotherapy now under observation and regular follow-up. All the patients exhibited significant tumor reduction following chemotherapy, enabling successful surgical intervention. All patients remained in remission post-treatment. NACT showed effectiveness in reducing tumor size and facilitating successful radical surgery in patients with stage 1B3 cervical cancer. Our case series highlights the potential of NACT followed by radical surgery as a promising therapeutic strategy for stage 1B3 cervical cancer. NACT facilitated successful surgical intervention with favourable outcomes. Further research is warranted to elucidate the optimal patient selection criteria and the long-term benefits of this approach in improving survival rates and quality of life for cervical cancer patients.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14001 Maternal near miss mortality: indication of maternal care 2024-03-05T13:18:34+0530 Maryam Ali drmaryamali298@gmail.com Manju Prabhakar drmayamali298@gmail.com Anjani Sai Kuracha drmayamali298@gmail.com <p>Maternal mortality is one of the important indicators used for the measurement of maternal health. To overcome this challenge, maternal near miss has been suggested as a compliment to maternal death. The prevalence of near miss is higher in developing countries and causes are similar to those of maternal mortality namely haemorrhage, hypertensive disorders, sepsis and obstructed labor. Reviewing near miss cases provide significant information about the delays in health seeking so that appropriate action is taken. It is useful in identifying health system failures and assessment of quality of maternal health-care. Certain maternal near miss indicators have been suggested to evaluate the quality of care. The near miss approach will be an important tool in evaluation and assessment of the newer strategies for improving maternal health. Here we are presenting case series of near miss mortality cases reported in Muzaffarnagar medical college.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13984 Male factor infertility with Azoospermia: our experience in a tertiary care centre 2024-02-29T18:35:16+0530 Sandeep Sethumadhavan P. sandeepsp5527@gmail.com Rajesh Sharma drrajesh34@yahoo.in Vikas Dhawan vikasdhawan76@yahoo.co.in Sushil Chawla chawla_sushil@reddiffmail.com <p>Azoospermia is the absence of spermatozoa in two separate centrifuged semen samples. It is one of the major contributors of male factor infertility. Usually detected in the course of infertility evaluation. Many forms of azoospermia are amenable to medical treatment. Authors report a case series of 16 cases of infertility with Azoospermia which were managed in the Assisted reproductive technology centre of a tertiary care teaching hospital of the Indian Navy in Mumbai between Jun 2022 to Jul 2023. Out of the 16 cases 13 cases underwent surgical sperm retrieval by PESA/TESE. We could retrieve sperms in 11 cases. In 5 cases the retrieved sperms were motile and in 6 cases immotile sperms were obtained. ICSI done with both motile and immotile sperms resulted in fertilization. Our study shows that IVF-ICSI can produce successful fertilization even with Immature sperms or sperms obtained directly from the testicular tissue and IVF-ICSI allows for pregnancy in couple where the man has irreversible azoospermia as long as it is possible to recover sperm from the testes.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14025 Sero-prevalence and associated factors of hepatitis B virus infection among antenatal women at booking in a tertiary hospital 2024-03-14T21:36:43+0530 Nonye-Enyidah Esther Ijeoma hernsi@yahoo.com Altraide Basil O. A. hernsi@yahoo.com Enyidah Nonyenim Solomon hernsi@yahoo.com Jumbo I. Awopola hernsi@yahoo.com Abbey Mkpe hernsi@yahoo.com <p><strong>Background:</strong> Hepatitis B virus (HBV) infection is a global public health problem affecting about two billion people worldwide. About 95% of the infection is acquired during the perinatal period. Though studies have been carried out on these in different parts of Nigeria, information regarding the prevalence and risk factors of HBV infection in antenatal clinic attendees in south-south Nigeria is scanty. We determined the sero-prevalence of hepatitis B surface antigen (HBsAg) and the associated factors among pregnant women in south-south, Nigeria.</p> <p><strong>Methods:</strong> A retrospective study carried out at the antenatal clinic of Rivers State university teaching hospital (RSUTH) between 1<sup>st</sup> January, 2015 and 31<sup>st</sup> December, 2020. At booking visit, 9,990 women were tested for HBsAg. Data was analyzed using the IBM SPSS version 23.0. P&lt;0.05 was considered statistically significant.</p> <p><strong>Results: </strong>A total of 9,990 women were screened for HBV infection. Prevalence of HBV infection was 160 (1.6%). Age group 30-39 years had most HBV infection, 103 (64.4%). Most who were positive for HBsAg were married 158 (98.7%), traders 45 (28.1%), para 2-4, 65 (40.6%); in their second trimester, 78 (48.8%) and with tertiary level of education 111 (69.3%). Associated factors of HBV infection with statistically significant difference in proportion of HBsAg positives and negatives include gestational age, educational status, occupation, presence of HIV and VDRL.</p> <p><strong>Conclusions:</strong> Although the study reveals a low prevalence of HBV infection, continued routine screening for HBV infection is highly recommended.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13964 Effect of polycystic ovary syndrome on dysmenorrhea: a case-control study 2024-02-24T20:00:25+0530 Samaneh Behzadfar s.behzadfar@gmail.com Faranak Jalilvand faranak.jalilvand2019@gmail.com Narges Salehi narghessalehi7@gmail.com <p><strong>Background</strong><strong>:</strong> Polycystic ovary syndrome (PCOS) is a common endocrine disorder that has an important impact on women of reproductive age and is diagnosed with various hormonal disorders. Menstrual pain is a common and often problematic problem for women during their reproductive age. Although these two problems may appear to be presented separately, they often overlap and lead to complex and multiple challenges in health care for women. This study was conducted with the aim of the effect of PCOS on dysmenorrhea.</p> <p><strong>Methods</strong><strong>:</strong> This case-control study was done on 92 women who visited Alavi hospital in Ardabil during 2022-2023. Data collected included age, body mass index, length of the menstrual cycle (in days), menstrual bleeding volume (number of pad changes during the menstrual cycle), duration of menstrual bleeding (in days), and the presence of menstrual pain. Additionally, the severity of menstrual pain was assessed using the visual analog scale (VAS). Data were analyzed using SPSS version 25.</p> <p><strong>Results</strong><strong>:</strong> Mann-Whitney test showed a significant difference between subjects with PCOS and non-PCOS in terms of the frequency of pain scores (p=0.03). There was no significant difference between the two groups in the variable of pain intensity (p=0.70).</p> <p><strong>Conclusions: </strong>The results of this study showed that the frequency of dysmenorrhea increases in people with PCOS, but the intensity of menstrual pain does not increase.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13995 Mistreatment in the gynaecology and obstetrics units of health facilities: community women's experiences in Guinea 2024-03-03T17:09:39+0530 Alpha Oumar Sall asall6988@gmail.com Ramata Diallo asall6988@gmail.com Mamadou Dioulde Balde asall6988@gmail.com Sadan Camara asall6988@gmail.com Kabinet Kourouma asall6988@gmail.com Madeleine Toure asall6988@gmail.com Aissatou Diallo asall6988@gmail.com Tiany Sidibe asall6988@gmail.com Felix Millimono asall6988@gmail.com Ousmane Balde asall6988@gmail.com <p><strong>Background:</strong> Improving maternal and child health helps to ensure women's well-being. However, despite many efforts, women are still subjected to mistreatment and abuse in health facilities such as gynaecology and obstetrics units. Data on women's mistreatment in gynaecology are scarce and insufficient in obstetrics departments. This study therefore analyses women's experiences of mistreatment in these services in Guinea.</p> <p><strong>Methods:</strong> This study is based on a qualitative approach using in-depth individual interviews and group discussions with community women. The data was subjected to thematic analysis.</p> <p><strong>Results:</strong> This study revealed a high prevalence of mistreatment of women in health facilities, both during provision of gynaecological services and in obstetric units (pregnancy, prenatal consultations and childbirth). They are mainly victims of verbal abuse, negligence and informal payment, and to a lesser extent physical violence. Victims generally have few means of redress. This mistreatment is encouraged above all by the lack of training for health care providers, the inadequacy of services and the absence of sanctions. To prevent and combat this phenomenon, it is necessary to organise training courses on respectful maternal care for healthcare providers, make patients aware of their rights and the culture of consent, and apply disciplinary sanctions.</p> <p><strong>Conclusions:</strong> This study has enabled us to understand the types and extent of mistreatment suffered by women in obstetrics and gynaecology units. It identified measures to be taken to prevent and combat mistreatment in these units in order to ensure respectful healthcare and improve relations between healthcare providers and their clients.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14027 Dehydroepiandrosterone supplementation improves reproductive outcomes in women of the POSEIDON IV group 2024-03-15T01:01:16+0530 Eugenia Irene Morán-Orozco eugeniamoran969@gmail.com Jorge Luis Lezama-Ruvalcaba eugeniamoran969@gmail.com Gerardo A. Paladino-Barquera eugeniamoran969@gmail.com Jose Carlos Salazar-Trujillo eugeniamoran969@gmail.com David Alejandro Laguna-Pérez eugeniamoran969@gmail.com Carlos G. Salazar-López Ortiz eugeniamoran969@gmail.com Jaime Antonio Hidalgo-Carrera dr.jaime.hidalgo@gmail.com <p><strong>Background:</strong> The decrease in ovarian reserve has become one of the main causes of infertility. Recent studies have sought to improve the reproductive outcomes of these women through adjuvant treatments. In patients undergoing assisted reproduction treatments, exogenous Dehydroepiandrosterone (DHEA) or prasterone acts as a precursor to testosterone in the follicular fluid, which increases steroidogenesis and the number of primary and antral follicles.</p> <p><strong>Methods:</strong> A quantitative, quasi-experimental case series study was carried out in the clinical area of assisted reproduction from August 2021 to March 2022. All women included were over 34 years and categorized as POSEIDON IV. They were supplemented with 100 mg of DHEA one month prior to the follicular capture. Data was collected from the records of the patients who met the inclusion criteria, including the antral follicle count on the first three days of the menstrual period before the supplementation and one month after. Finally, the number of metaphase II oocytes and blastocysts obtained were analyzed.</p> <p><strong>Results:</strong> There were 22 women underwent controlled ovarian stimulation; there was a difference in antral follicle count from 5±2.1 SD to 8.23​±4.29 SD (p=0.004) and MII oocytes 3.25±2.31 to 4.53±3.27 (p=0.04) before DHEA and after DHEA, respectively.</p> <p><strong>Conclusions:</strong> DHEA or prasterone supplementation can be used as an adjuvant treatment in women of the POSEIDON IV group one month before the ovarian stimulation to improve their reproductive outcome.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14050 Prevalence and determinants of cesarean section in a rural tertiary care hospital of Bangladesh 2024-03-22T19:29:16+0530 Fatema Begum drfatema.parul@gmail.com Saida Akter drfatema.parul@gmail.com Arshad Jahan drfatema.parul@gmail.com Luna Farhana Hoque drfatema.parul@gmail.com M. Nasrin Aktar drfatema.parul@gmail.com <p><strong>Background:</strong> Cesarean section (CS) stands as the foremost major surgical procedure in contemporary obstetrics. Initially developed primarily to safeguard maternal life during challenging childbirth scenarios, its prevalence has shown a concerning upward trajectory in recent times. The aim of this study was to investigate the prevalence and determinants of Cesarean section deliveries in a rural tertiary care hospital.</p> <p><strong>Methods:</strong> This was a retrospective observational study and was conducted in the Department of Obstetrics and Gynaecology of Khwaja Yunus Ali Medical College &amp; Hospital, Sirajganj, Bangladesh during the period from January 2018 to December 2019.</p> <p><strong>Results:</strong> Out of a total of 1600 deliveries, 390 (24.4%) were vaginal deliveries, while 1210 (75.6%) were cesarean sections respectively. Majority 94.8% patients were 20-34 years old, 1.8% were less than or equal to 19 years and 3.4% were great than or equal to 35 years old respectively. The majority of cesarean sections, 814 (67.3%), were performed as elective procedures and 396 (32.7%) were performed as emergency procedures respectively. Majority 512 (42.3%) were performed on women who had a history of previous cesarean deliveries, 34 (2.8%) were performed due to non-progression or prolonged labor, 99 (8.2%) were performed due to malpresentation of the baby and 308 (25.5%) were performed at the request of the mother respectively.</p> <p><strong>Conclusions:</strong> In conclusion, this retrospective observational study provides valuable insights into the prevalence and determinants of caesarean sections in a rural tertiary care hospital.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14021 Factors associated with decision-making on family planning use among women aged 15-49 in Guinea 2024-03-14T15:33:58+0530 Tiany Sidibe sidibetiany@gmail.com Sadan Camara camarasadan8@gmail.com Madeleine Toure mariemadeleinetoure@gmail.com Aissatou Diallo aissatoulabo90@gmail.com Ramata Diallo diallo.ramatadr@gmail.com Alpha Oumar Sall asall6988@gmail.com Fanta Barry fantb244@gmail.com Kaba Saran Keita kabassan85@gmail.com Ibrahima Conte conteib1976@gmail.com Mamadou Dioulde Balde baldemddka@gmail.com <p><strong>Background:</strong> In Guinea, several factors affect women's ability to make decisions about contraceptive use. The objective of this study was to identify factors associated with married women's decision-making power regarding family planning use in Guinea.</p> <p><strong>Methods:</strong> Data from the 2018 Guinea Demographic and Health Survey were used. A sample of 752 women was included in the study. Multivariate logistic regression was performed to determine the factors associated with women's decision-making power regarding the use of family planning in Guinea. The Odd ratio with 95% confidence interval was calculated for the variables in the final model.</p> <p><strong>Results:</strong> The overall prevalence of women deciding to use family planning was 65.47% [95%CI: 62.18 68.61]. Urban women had a 49% lower chance of deciding to use family planning than rural women (adjusted OR=0.61; 95% CI [0.238 0.92]). Similarly, women with secondary education were 3.53 times more likely to use family planning than those with no formal education (adjusted OR=3.53; 95% CI [1.27 9.78]).</p> <p><strong>Conclusions:</strong> This study shows the importance of several factors in women's decision-making power regarding family planning use in Guinea. Women with secondary education, those in the Kindia and Kankan regions, and those with a job had higher probability of deciding to use family planning. Findings from this study could help guide public health policies, emphasising the importance of education, employment and access to health services in improving women's decision-making power when it comes to family planning in the Republic of Guinea.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14000 Role of thyroid abnormality in perimenopausal abnormal uterine bleeding 2024-03-04T21:14:19+0530 Sonali Abhinav Deshmukh sonalideshmukh4786@gmail.com Jyotsna Deshmukh admanejyo25@yahoo.co.in Athulya Surendran admanejyo25@gmail.com <p><strong>Background:</strong> Diagnosing and treating abnormal uterine bleeding (AUB) presents special problems during the perimenopausal era, which often need for a thorough study of contributory variables. Comprehending the relationship between perimenopausal AUB and thyroid function has important therapeutic ramifications that might influence customized treatment plans and enhance patient outcomes.</p> <p><strong>Methods:</strong> This prospective research sought to determine the significance of thyroid anomalies in perimenopausal AUB. It was carried out at the Department of Obstetrics and Gynecology, Rajashri Chatrapati Shahu Government Medical College, and Chatrapati Pramila Raje hospital. Data was carefully collected over a 6-month period, from April to September 2018, and placed into excel spreadsheets for statistical analysis. The goal of the research is to clarify the connection between perimenopausal AUB and thyroid dysfunction by using the proper statistical tests.</p> <p><strong>Results:</strong> Out of 120 individuals with severe menstrual bleeding, 80 had hypothyroidism. Hyperthyroidism affected 45 hypomenorrhea and irregular menstrual cycle individuals. Thyroid issues are commonly ignored, and patients are given estrogen progesterone tablets without thyroid function testing.</p> <p><strong>Conclusions:</strong> By providing insights into its complex etiology and opening the door for more focused therapy approaches in this patient population, this study aims to further our understanding of AUB.</p> <p><strong> </strong></p> 2024-04-06T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14113 FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in non-gravid women 2024-04-16T13:51:21+0530 Forum J. Trivedi drforum20@gmail.com Kruti J. Deliwala drforum20@gmail.com Dhanvi J. Deliwala drforum20@gmail.com Shlok V. Patel drforum20@gmail.com <p><strong>Background:</strong> Abnormal uterine bleeding is one of the most common problems of the women of reproductive age group leading to increased number of hospital visits. International federation of gynecology and obstetrics (FIGO) has suggested a new etiological classification system polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified, known by the acronym PALM-COEIN to standardize the terminology, investigations, diagnosis and management of abnormal uterine bleeding (AUB) in non-pregnant women of reproductive age group.</p> <p><strong>Methods:</strong> This is a retrospective study on 150 patients of abnormal uterine bleeding to categorize them on the basis of PALM-COEIN classification. Patients were grouped under these categories after detailed history, examination, investigations and histopathological reports.</p> <p><strong>Results:</strong> Ovulatory dysfunction was the most common cause of AUB in patients presenting to the gynecology outpatient department (n=42, 28%). It was followed by leiomyoma (n=37, 24.67%) and endometrial causes (n=23, 15.33%). They constitute the top 3 causes of AUB. Adenomyosis (n=22, 14.67%), not known (n=10, 6.67%), iatrogenic (n=5, 3.33%), polyp (n=6, 4%), coagulopathy (n=1, 0.67%) and malignancy (n=4, 2.66%) contributing least to the PALM-COEIN classification as an etiology for AUB.</p> <p><strong>Conclusions:</strong> The PALM COEIN classification system is useful in understanding various etiological causes of AUB, facilitates accurate diagnosis and hence helps in optimizing the treatment.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14065 Study of consumption of blood and blood components in emergency obstetrics patients 2024-03-27T19:00:40+0530 Zeel R. Vaghela zeelvaghela97@gmail.com Bhavna N. Mewada drbhavnamewada@gmail.com Akash J. Patel hsakapatel25@gmail.com Labdhi M. Kapadia labdhikapadia30@gmail.com <p><strong>Background:</strong> Most of the emergencies in the labour room, which require blood and blood product transfusion includes, complications of abortion, placenta previa, ruptured ectopic pregnancy and haemorrhage in labouring patients. Patients may come with severe anaemia and may develop post-partum haemorrhage or any other complications resulting in massive blood loss and rapid deterioration in well-being of the mother. Blood transfusion has become life-saving in management of haemorrhage in obstetric patients. However, like all treatments, it may result in acute or delayed complications.</p> <p><strong>Methods:</strong> This retrospective study has included the patients who came with obstetric emergencies requiring blood and blood products during antepartum, intrapartum and postpartum period at the obstetrics and gynaecology department, at tertiary care hospital between December 2022 to December 2023.</p> <p><strong>Results:</strong> Multigravida patients required more blood transfusion (69.23%) compared to primigravida (30.76%). Anaemia (38.46%) was the commonest indication for blood transfusion followed by post-partum haemorrhage (21.53%). Fever and shivering (3.07%) were seen to be the commonest adverse reactions. This study observed 92.3% live birth and 7.7% intrauterine foetal demise. Wound gap developed in 3(4.61%) patients following blood and blood products transfusion.</p> <p><strong>Conclusions:</strong> Transfusing blood or its components holds utmost importance in comprehensive obstetric care, as emphasised by the current study. Haemorrhage in labouring patients and anaemia are leading causes of maternal morbidities and mortalities. The most effective outcomes in management are achieved through a carefully planned multidisciplinary protocol. Prompt availability of blood and blood components helps to avert mortality in a considerable number of cases.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13960 Evaluation of the complete profile of male partners in infertile couples with special emphasis on detection of genital tuberculosis 2024-02-23T19:45:15+0530 Niharika Sethi niharikasethi26@gmail.com Karandeep Guleria kdpguleria@gmail.com Devender Verma devender123@gmail.com Anjali Tempe anjalitempe@hotmail.com <p><strong>Background:</strong> To evaluate the complete profile of male partners in infertile couples with special emphasis on detection of genital TB.</p> <p><strong>Methods:</strong> The study was conducted in the fertility clinic of department of obstetrics and gynaecology, Maulana Azad Medical College and Associated Lok Nayak and GB Pant Hospitals, New Delhi from August 2015 to December 2016 among 100 infertile couples. Detailed history, general physical and local examination of male partners was done. Routine blood and urine tests, combined with radiology examination of chest and mantoux skin test of male partners were done followed by investigations specific to male factor evaluation. Two semen samples collected after 3-5 days of sexual abstinence were analyzed to assess semen parameters such as volume, total sperm count, total motility and morphology. Ultrasound and colour Doppler of scrotum and hormone analysis was done in all cases of azoopermia, oligoasthenospermia or asthenospermia. Testicular FNAC was done for all cases of azoospermia and oligoasthenospermia to establish cause of male infertility.</p> <p><strong>Results:</strong> 72% couples had primary infertility. 34% males were daily tobacco chewers. 8 males had varicocele and 2 had undescended testes on examination. 60% males had semen analysis in the normal range and 19% had azoospermia. Tobacco chewing, testicular size abnormalities, varicocele, hydrocele were significantly associated with abnormal semen findings. A statistically significant relation was found between elevated S.FSH and semen analysis findings. A statistically significant association was found between penile meatal stenosis, chest X-ray, mantoux test with history of TB in male/female partner.</p> <p><strong>Conclusions:</strong> Primary infertility was more common than secondary infertility in our study group. Addiction was found to be an important factor in infertile men particularly tobacco chewing. Elevated Serum FSH levels were a common finding in males with azoospermia and oligoasthenospermia.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13970 Feto-maternal outcome of pregnancy with thrombocytopenia 2024-02-26T17:18:16+0530 Kinjal K. Kharadi kinjalkharadi123@gmail.com Sapana R. Shah kinjalkharadi123@gmail.com Kruti J. Deliwala kinjalkharadi123@gmail.com Purvi M. Parikh kinjalkharadi123@gmail.com <p><strong>Background:</strong> Thrombocytopenia is the second most haematological abnormality in pregnancy where the platelets count below 1,50,000/µl. Gestational thrombocytopenia is most common cause of thrombocytopenia, accounts for 70% of thrombocytopenia in pregnancy.</p> <p><strong>Methods:</strong> It is retrospective study with 30 antenatal women at any gestational age having thrombocytopenia, platelet count less than 1,50,000/µl at SVP Hospital, Ahmedabad during duration of May 2023-November 2023. All the pregnant women who attend OPD and admitted in SVP Hospital, Ahmedabad were included in the study.</p> <p><strong>Results:</strong> The present study found that gestational thrombocytopenia (53.34%) accounted for most common cause of thrombocytopenia, followed by hypertensive disorders (10.0%), HELLP syndrome (6.67%), dengue and malaria (6.67%), DIC (6.67%) and ITP (3.34%) in which 53.34% women has mild, 36.67% has moderate and 10% has severe thrombocytopenia. In this study vaginal delivery accounts for 33.34% and caesarean delivery accounts for 66.67%. In present study 50.0% patient of gestational thrombocytopenia didn’t required any treatment. About 6.67% patients required transfusion of PRC and 33.34% of neonates needed NICU admission. Neonatal mortality due to complications like prematurity, septicemia was seen in 10.0% of the cases.</p> <p><strong>Conclusions:</strong> Outcome of pregnancy with moderate to severe thrombocytopenia depends mainly on the etiology of thrombocytopenia. Early interdisciplinary evaluation of thrombocytopenia during pregnancy can help in optimizing care as fetal outcomes and management depend on the etiology.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13972 Impact of simulation-based-teaching in obstetrics and gynecology in under-graduate medical education 2024-02-27T11:55:23+0530 Satwant Kaur beenamahaur@yahoo.com Beena Mahaur beenamahaur@yahoo.com Tanya Kumar beenamahaur@yahoo.com Ankit Aneja beenamahaur@yahoo.com <p><strong>Background: </strong>Simulation based teaching (SBT) is an evolving teaching-learning method (TLM) that can enhance skill acquisition among students while providing multiple practice sessions, before on-patient implementation helping to improve confidence and competency among medical students.</p> <p><strong>Methods: </strong>The study was conducted among 150 students of Phase II MBBS students of Adesh medical college and hospital, KKR, Haryana, from April 2022 to October 2022 on batches of 30 students each during their clinical postings of 4 weeks in the OBG department. They were further divided into batches of 10, and given didactic lecture on the selected topic. Following which, the facilitators demonstrated the skill. The students were allowed to practice individually. There doubts were cleared. An OSCE evaluation of the skill was made, followed by a debriefing session. A feedback form was then filled by both students and facilitators to assess impact of SBT.</p> <p><strong>Results: </strong>Among the 150 students of phase II MBBS students, 146 responses were received. Both the medical students and the facilitators showed high levels of satisfaction with SBT. About 60.27% (88) students had a good overall experience with this new TLM.</p> <p><strong>Conclusions:</strong> SBT improves retention as well as understanding of the concept. The teachers witnessed improved confidence and enhanced overall performance. The current study concludes that SBT is a highly effective tool and should be firmly inculcated in medical education.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13975 The study of fetomaternal outcome in second stage caesarean section 2024-02-27T22:50:35+0530 Aaesha Khanam dr.aaeshakhanam@gmail.com Shanti Sri A. drshanti_asuri@fernandez.foundation Maimoona Ahmed azulemontana@gmail.com <p><strong>Background: </strong>Caesarean section is commonly perceived as a simple alternative to difficult vaginal birth and in the recent years its prevalence during the second stage is increasing. Caesarean section in second stage of labor has additional associated risks for the mother such as obstetric hemorrhage, extended uterine tear, bladder injury and longer hospital stay. It is also associated with increased neonatal morbidity in terms of NICU admissions, fetal acidemia, hypoxemia and prolonged NICU stay. This study was conducted to know the indications of second stage caesarean section and to assess maternal and neonatal outcomes in second stage caesarean section.</p> <p><strong>Methods: </strong>We conducted a prospective observational study conducted at a tertiary perinatal care center from August 2021 to August 2022. All second stage caesarean sections performed during this period were analyzed in terms of indication for caesarean section, intraoperative, postoperative complications and fetal outcomes.</p> <p><strong>Results: </strong>During the study period there were a total of 10433 deliveries. Out of this, 5392 deliveries done by caesarean section, in which 67 were second stage caesarean section. Deep transverse arrest was the most common indication for caesarean section in second stage of labor. Most common intra operative complication was uterine atony, seen in 32.5% cases. 16 (24%) NICU admission were noted with respiratory distress being the most common indication. 15 (23%) had post operative complications like febrile illness.</p> <p><strong>Conclusions: </strong>Second stage caesarean section is associated with significant maternal and neonatal morbidity. A skilled obstetrician and proper training are required to take appropriate decisions for caesarean section at full dilatation of cervix.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13978 The fetomaternal outcome in case of post-dated pregnancy at tertiary care center 2024-02-28T15:32:37+0530 Prachi Chaudhari prachichaudhari66@gmail.com Hafsa Vohra drhafsa302@gmail.com <p><strong>Background: </strong>Post-date pregnancy is a challenge for maternal and perinatal care and a leading cause of neonatal morbidity and mortality. The aim of the present study was to analyse the risk factors and feto-maternal outcome of pregnancies which goes beyond due date.</p> <p><strong>Method: </strong>It is a prospective study carried out during period from October 2021 to October 2022 in obstetrics and gynecology department of B. J. medical college and hospital, Ahmedabad. 100 cases of post-dated pregnancy out of 12,885 delivered cases were studied in this study.</p> <p><strong>Results:</strong> The present study was conducted in the hospital for risk factors leads to post-dated pregnancy and maternal and neonatal morbidity and mortality. Among the 12,885 deliveries, 990 were post-dated pregnancy and 100 cases studied in this study. In the present study, incidence of post-dated pregnancy 7.6%. Majority of women belonged to age group 21 to 25 years (66%). 68% of them delivered vaginally, 32% women required caesarean section, the most common indication being foetal distress, 57% of women were given induction by various means and 32% of them had successful vaginal delivery.19% babies had NICU admission with respiratory distress (7%) being the most common reason.</p> <p><strong>Conclusions:</strong> Post-dated pregnancy is high risk condition which is challenge to obstetrician and leads to maternal and neonatal complications. A better management is a pre-requisite to reduce the rate of perinatal mortality and morbidity in this group of patients. With regular antenatal check-up, the incidence of post-dated pregnancies can be decreased.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13985 Acceptability of contraceptive methods in lactating mothers in a tertiary centre 2024-03-01T05:42:30+0530 Swetha Mude swethamude@gmail.com Anju Singh singha1712@gmail.com Vanita Suri surivanita@yahoo.co.in Rimpi Singla drrimpisingla@gmail.com Rashmi Bagga rashmibagga@gmail.com Vanita Jain drvanitajain@yahoo.com Snigdha Kumari snigdha.obs@gmail.com <p><strong>Background:</strong> High fertility rate, high maternal mortality and high infant mortality rates are the shared problems of the all the developing countries of the world. According to Directorate of Health Services surveys, 40% of women who intend to use a family planning method in the first year postpartum are not using one. Contraceptive use is negligible among postpartum women, particularly young mothers. We aimed to determine the reasons for acceptability, non-acceptability, side effects and continuation of four contraceptive methods condoms, Depotmedroxyprogesterone acetate, (DMPA), copper intrauterine contraceptive devices (IUCD), progesterone only pills (POPs) in lactating mother after 6 weeks of delivery.</p> <p><strong>Methods:</strong> A total of 200 healthy nursing mothers, who needed contraception were enrolled in this prospective observational study. Women were explained about all four contraceptive methods used for the study. The reason for accepting a particular method was sought. The study participant were followed up at third and sixth month and side effects, failure rate, continuation rates, reasons for discontinuation of method were assessed.</p> <p><strong>Results:</strong> The most acceptable method was condom (40.5%) followed by DMPA (31%), IUCD (20.5%) and POPs (8%). The most common reason for selection of condom was fear of side effects with other methods (66%). Long acting method like DMPA and IUCD has good continuation rate of 87% and 85% respectively. Failure of contraception was seen only with condoms (2.8%).</p> <p><strong>Conclusions:</strong> This study showed condoms was most acceptable method but had failure whereas DMPA and Cu-IUCD have high continuation rate with no failure.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13988 A study of knowledge, attitude, practice, and preferences of contraceptive methods in women of district Saharanpur, Uttar Pradesh 2024-03-02T18:55:48+0530 Rashmi Singh dr.rashmisingh15@gmail.com Himanshu Pal Singh dr.rashmisingh15@gmail.com Antriksh Bajaj dr.rashmisingh15@gmail.com Deepak Bhaskar dr.rashmisingh15@gmail.com <p><strong>Background:</strong> Studies have shown that despite the increase in contraceptive uses over the years, there still exist a gap in the knowledge, attitude and practice regarding contraception. The present study has been designed to study the knowledge, attitude, practice and preferences of contraceptive methods in women of district Saharanpur, to determine the association between knowledge and attitude on contraceptive methods with the variables.</p> <p><strong>Methods:</strong> A cross sectional descriptive study of 150 females coming to gynaecology OPD using a self-administered questionnaire on knowledge, attitude, scale, practice and preferences was done at GMC, Saharanpur between February 2023 - April 2023.</p> <p><strong>Results:</strong> Among 150 participants included 42% were between 18-25 years of age.58.6% were from rural area. 68.6% were Muslims. 32% had primary education and 27.3% had secondary. 84% had their marriage between 19-25 years of age. 92.6% were housewives. 68.6% had a family income between ₹10,001 to ₹15,000. 53.3% belong to nuclear family. 42% of participants had 3 or more children. 68% had moderate knowledge on contraceptives, accounting from media which were 32% followed by health care workers which was 30%. Majority had a favourable attitude towards contraceptive methods, 77%. 2.6% did not use any contraceptive methods. 25.3% used barrier methods, followed by OCP usage at 21.3%. There was an association between knowledge, education, residence, family size and age in years.</p> <p><strong>Conclusions:</strong> The study showed that majority of the females had moderate knowledge and favourable attitude towards contraceptive usage.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13993 A study of fetal outcome in patients with premature rupture of membranes with gestational age more than 28 weeks 2024-03-02T20:35:59+0530 Shantanu H. Rajmane rajmaneshantanu@gmail.com Mamta Anand rajmaneshantanu@gmail.com J. B. Senapati rajmaneshantanu@gmail.com <p><strong>Background:</strong> Premature rupture of membranes is rupture of membranes before the onset of labour irrespective of gestational age. If it occurs before 37 weeks, it is called as preterm premature rupture of membranes (PPROM). Once PROM delivery is inevitable, so neonatal prognosis depends on gestational age at which PROM occurs. Neonatal complications include prematurity and its complications mainly, also pulmonary hypoplasia due to severe oligohydramnios, skeletal and joint deformities to foetus due to compression, increased risk of neurodevelopmental impairment and neonatal white matter damage. PROM is a still one of the most difficult and controversial problems in obstetrics.</p> <p><strong>Methods:</strong> A prospective longitudinal study was conducted in Department of Obstetrics and Gynaecology at a tertiary care hospital from 2021 to 2023 (18 months). A total of 275 patients admitted with complaints of per vaginal leaking with gestational age more than 28 weeks were studied. A multivariate analysis was used to find association between PROM and foetal outcome.</p> <p><strong>Results:</strong> In this study, 57% (157) new-borns had birth weight &gt;2.5 kgs, 60% (166) new-borns had APGAR score 8/10, 71% (196) new-borns were term, 40% (109) had NICU stay, 6% (17) had respiratory distress syndrome (RDS), 3% (8) had neonatal sepsis, 2% (6) had neonatal hypoglycaemia and perinatal mortality rate was 1% (3).</p> <p><strong>Conclusions:</strong> Once there is PROM, delivery is imminent. Neonatal outcome can be improved significantly after administration of steroids and antibiotics. To get that time short term tocolysis can be used. During that time foeto-maternal monitoring should be done for early detection of chorioamnionitis. Looking after preterm infants puts an immense pressure on family, economy and health care resources. The prevention of PROM is difficult so more focus should be on management of PROM.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13994 Comprehensive assessment of menstrual cup awareness and utilization among degree students 2024-03-03T11:49:36+0530 Varalaxmi Gottiparti vrmshankar@gmail.com Amisha Jose vrmshankar@gmail.com Ayana E. V. vrmshankar@gmail.com Sheelam Sravani vrmshankar@gmail.com Madanu Deepika vrmshankar@gmail.com Aleena Jose vrmshankar@gmail.com Thakur Anusha vrmshankar@gmail.com Roslin Babu vrmshankar@gmail.com Uyyala Swetha vrmshankar@gmail.com Vallapudasu Maheswari vrmshankar@gmail.com <p><strong>Background:</strong> Menstrual hygiene management poses significant challenges for girls in low-income environments, particularly in educational settings, where cultural norms, inadequate knowledge of recommended hygiene practices, and restricted access to affordable menstrual products hinder effective menstrual care. The vaginal menstruation cup emerges as a potential alternative to traditional sanitary pads or tampons, offering a sustainable and cost-effective solution.</p> <p><strong>Methods:</strong> The research approach was quantitative research, and the research design adopted was a one-group pre-test and post-test design. The study was conducted among college students at selected colleges in Suryapet. The sample size was 60. The non-probability purposive sampling technique was used.</p> <p><strong>Results:</strong> Assessment of knowledge was done using a self-administered questionnaire, and practice was done using an observational checklist. Analysis showed that the pre-test mean knowledge score was 5.61±1.16 and the post-test mean knowledge score was 17.86±1.46. The pre-test mean practice score was 2.79±1.18, and the post-test mean practice score was 10.37±1.36. Analysis also reveals that (r =0.340, p = 0.009) a positive correlation was found between the knowledge and practice scores of students regarding menstrual cups. Analysis also reveals the calculated ‘t’ value for knowledge, i.e., 49.52, which shows the demonstration of knowledge regarding menstrual cups among college students was effective. The calculated ‘t’ value for practice, i.e., 30.84, shows the demonstration in practice was effective.</p> <p><strong>Conclusions:</strong> The study concludes that knowledge scores were associated with age, type of family, and education. Therefore, by statistically interpreting the data, the demonstration of knowledge and practice regarding menstrual cups among college students was effective. Consequently, the alternative hypothesis is accepted.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/13955 Role of magnetic resonance imaging in evaluation of vault prolapse 2024-02-27T21:03:01+0530 J. B. Sharma jbsharma2000@gmail.com Mukesh Kamal ashita.agg@gmail.com Kavita Pandey ashita.agg@gmail.com Smriti Hari ashita.agg@gmail.com Rajesh Kumari drrajeshkumari@yahoo.com Ashita Aggarwal ashita.agg@gmail.com Nisha N. pretty.nisha22@gmail.com Manasi Deoghare mancdeo@gmail.com <p><strong>Background:</strong> Vault prolapse usually follows vaginal or abdominal hysterectomy and is usually associated with cystocele, rectocele and enterocele. Diagnosis is made clinically but magnetic resonance imaging can better detect enterocele than clinical finding.</p> <p><strong>Methods:</strong> It was a prospective study over 3 years, so women presenting with vault prolapse, in which grading of vault prolapse was made clinically and by pelvic organ prolapse quantification (POPQ). Magnetic resonance imaging was performed for all cases to quantify prolapse and compare findings of MRI and POPQ with intraoperative findings of prolapse.</p> <p><strong>Results:</strong> Mean age, parity, BMI were 58.4 years, 3.5, 22.71kg/m<sup>2</sup> respectively. Most patients (75%) had vaginal hysterectomy while 25% had abdominal hysterectomy. Symptoms were pressure in lower abdomen and perineum (55%), bulge and feeling of mass descending in perineum (100%) and chronic constipation (60%). The type of prolapse was cystocele (100%), rectocele (100%), vault prolapse (100%) and enterocele (45%). MRI had agreement with intraoperative findings in 65% cases in cystocele, 45% cases in vault prolapse, 50% in rectocele but had much higher agreement of 88.8% for enterocele. While POPQ had higher agreement with intraoperative findings for cystocele (80%), vault prolapse (98%), rectocele (80%) but had poorer agreement for enterocele (66.6%).</p> <p><strong>Conclusions:</strong> This study demonstrated that MRI was inferior in diagnosis of cystocele, rectocele and vault prolapse than POPQ but was superior in identification of enterocele than POPQ.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14003 Neonatal outcome of babies born with congenital anomalies after pediatric surgery 2024-03-05T17:20:33+0530 Snigdha Sharma snigdha.2907@gmail.com Arti Sharma artishubh@yahoo.com Madhukar Maletha drmmadhukar@yahoo.co.in <p><strong>Background:</strong> Congenital anomalies are the major cause of adverse neonatal outcome and mortality. Some congenital anomalies are correctable and there is immense role of pediatric surgery in treatment of these anomalies. The aim of this study was to determine the pattern of congenital anomalies and to evaluate clinical outcome of babies after surgical intervention.</p> <p><strong>Methods:</strong> This hospital-based cross-sectional study was carried out in the Obstetrics and Gynecology department during the period of 1 year. All the delivered babies in this hospital during this period were examined by obstetricians and pediatricians for the presence of various congenital anomalies. Babies with correctable anomalies were operated by the Pediatric Surgery Department and outcome of babies at the time of discharge was included. Data were entered into a case record form and then in the excel sheet and were analyzed statistically.</p> <p><strong>Results:</strong> During the study period, 1670 babies were delivered in our institution; of which, 32 babies had congenital malformations, giving the prevalence of 1.91%. The system involved predominantly was the gastrointestinal (GI) system (80%). Pregnancy with congenital malformation were associated with malpresentation, anemia and polyhydramnios. Overall, most babies operated for pediatric surgery had good outcome.</p> <p><strong>Conclusions:</strong> Pre pregnancy high-dose folic acid supplementation, regular antenatal visits, and prenatal diagnosis are recommended for prevention, early detection and management of congenital anomalies. There is great importance of Level II and NT NB Scan. Pediatric surgery is a boon in babies with correctable anomalies.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14014 A retrospective analysis on the association between aetiology and symptomatology of ovarian carcinoma at a tertiary care centre 2024-03-11T23:26:17+0530 Kumari Ankita ankitamegha21@gmail.com Tushar Tatyaba Palve tusharpalve1977@gmail.com Rajashree Thatikonda rajashreethatikonda17@gmail.com Dishant Upadhyay dishantu1998@gmail.com <p><strong>Background:</strong> Ovarian cancer is a leading cause of cancer related mortality in women, but is often diagnosed during late stages since the symptomatology at onset of illness is often vague and inconsistent. Mortality and morbidity in carcinoma ovary patients are found to reduce dramatically when definitive diagnosis is arrived upon at early stages. Thus, the aim of our study was to analyse the symptomatology of diagnosed cases of carcinoma ovary with its known aetiology to elicit significant associations that may aid in diagnostic cues for this elusive disease. This study aimed to analyse the symptomatology of diagnosed cases of carcinoma ovary with its etiological factors.</p> <p><strong>Methods:</strong> In a retrospective design, data was collected from hospital records and interviewing known cases of ovarian cancer, age at presentation, age at first child birth, parity, BMI, family history, chief complaint at presentation was analysed.</p> <p><strong>Results:</strong> Abdominal pain was the chief complaint in majority of patients. Majority of the patients were having parity less than 2. Over one-third of patients had obesity. Age at presentation, age at first child birth, and parity were not associated or correlated with each other. Age at first child birth was significantly higher (27 years vs 22 years) in those having positive family history for ovarian cancer.</p> <p><strong>Conclusions:</strong> Later age of first child birth, obesity and parity less than 2 were found to have positive association with carcinoma ovary.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14020 Role of clinical examination, ultrasound findings and serum beta-hCG in first trimester vaginal bleeding 2024-03-13T10:20:30+0530 Hemapriya Lalchand drpriya_911@hotmail.com Praharshita Doddapaneni praharshitadoddapaneni@gmail.com <p><strong>Background:</strong> The significance of bleeding in first trimester of pregnancy may vary from an inconsequential episode to a life-threatening emergency. USG is safe and non-invasive and widely used for diagnosis various problems in pregnancy. Beta hCG can be detected in the plasma of a pregnant woman as early as eight days after ovulation, and its quantitative estimation can provide useful information regarding early pregnancy. Aim was to determine the role of clinical examination, ultrasonographic parameters and serum beta-hCG in predicting the outcome of pregnancy in first trimester vaginal bleeding.</p> <p><strong>Methods: </strong>It was a prospective observational study conducted in the department of OBG at JSS medical college, Mysuru for a duration of 18 months where in, serum beta-hCG levels, ultrasound examination was done in 120 patients presenting with first trimester of vaginal bleeding with gestational age less than 13 weeks.</p> <p><strong>Results: </strong>Out of 120 patients in our study, 39 patients had miscarriage and 81 patients had viable pregnancy at 28 weeks of gestation. Among those who had pregnancy loss, higher beta-hCG levels were found at 6-8 weeks of gestation. Higher incidence of miscarriage was found in association with subchorionic haemorrhage and smaller gestational sac. No statistically significant association between the pregnancy loss and ultrasound parameters was noted in our study.</p> <p><strong>Conclusions: </strong>The incidence of miscarriage in our study was 32.5%. No statistically significant association between the biochemical and ultrasonography parameters with pregnancy loss in patients presenting with threatened abortion could be established in our study.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14026 Clinical study of emergency obstetric hysterectomy in tertiary care center 2024-03-15T00:03:42+0530 Rishitha Reddy Yannam rishithareddy.ymr@gmail.com Harshini Thirumaran rishithareddy.ymr@gmail.com Kanchibhotla Meghana rishithareddy.ymr@gmail.com G. N. Vasantha Lakshmi rishithareddy.ymr@gmail.com <p><strong>Background:</strong> The aim of study was to assess the frequency, demographic features, reasons, and outcomes for both the mother and fetus linked to emergency obstetric hysterectomy.</p> <p><strong>Methods:</strong> We conducted a hospital based retrospective cohort study, between January 2016 to November 2023. A comprehensive study was conducted on 36 instances of emergency obstetric hysterectomy (EOH) at Sri Ramachandra institute of Higher Education and Research (SRIHER), Chennai, within the Department of Obstetrics and Gynecology. The study encompassed pregnant women delivering from 28 completed weeks of gestation to term, specifically those who underwent hysterectomy either during the intrapartum period or within the puerperium due to complications arising during childbirth.</p> <p><strong>Results:</strong> The incidence of EOH in our study was 22 per 1,00,000 following vaginal delivery and 196 per 1,00,000 following caesarean section. The overall incidence was 106 per 1,00,000 deliveries. Morbidly adherent placenta (39%) was the most common indication followed by Atonic postpartum hemorrhage (36%) and Placenta previa with placenta accreta (20%). Anemia (67%) emerged as the most prevalent maternal complication, with fever (30%) following closely behind.</p> <p><strong>Conclusions:</strong> In situations where traditional surgical methods prove ineffective and immediate access to interventional radiology is unavailable, a well-balanced approach to EOH can be life-saving. Our study underscores the significance of EOH in the coming years, given the increasing probability of both cesarean sections and multiple pregnancies.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14030 Impact of pelvic rocking exercise on dysmenorrhea among adolescent girls 2024-03-15T15:43:36+0530 Banashri Saikia banashrisaikia04@gmail.com Bhavani B. B. bhavanibb@yahoo.com Logambal K. k.logambal@gmail.com Karpagam S. bhavanibb@yahoo.com <p><strong>Background:</strong> Pelvic rocking exercise is an exercise which contracts deep abdominal muscles and buttocks by taking deep breath, so that a small movement takes place inside the uterus. It is an exercise which strengthens the muscles of lower abdomen and back by taking deep breath. So that the pressure on blood vessels in the area around uterus is relieved. It helps to relieve menstrual discomfort through increased vasodilatation and subsequent decreased ischemia, release of endogenous opiates and suppression of prostaglandins. It is a non-pharmacological management of dysmenorrhea. It increases endorphin release which decreases pain perception and to suppress prostaglandin release. It is found to be effective in managing stress and is easy to practice. Present study aimed to evaluated the effectiveness of pelvic rocking exercise on dysmenorrhea.</p> <p><strong>Methods:</strong> Pre- experimental one group pre-test post-test design has been used to attain the objectives of the present study. 60 adolescent girls were selected by non- probability purposive sampling technique. Sociodemographic variables, menstrual history related data was collected and standardized Numerical Pain Rating Scale was used to assess the level of dysmenorrhoea among adolescent girls. Pelvic rocking exercise was the intervention done to evaluate its effect on the level of dysmenorrhea.</p> <p><strong>Results:</strong> Out of total adolescent girls, majority had moderate level of dysmenorrhea. There was a significant difference between the pre and post- intervention level of dysmenorrhoea.</p> <p><strong>Conclusions:</strong> Study concluded that the intervention of pelvic rocking exercise was significantly effective in reduction of dysmenorrhoea among the adolescent girls.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14031 A prospective study on the outcome of pregnancies with a history of prior single or multiple early pregnancy losses 2024-03-15T15:30:59+0530 Mosam R. Patel patelmosam294@gmail.com Niketankumar Rathod patelmosam294@gmail.com Jalpa K. Bhatt patelmosam294@gmail.com Manishkumar K. Patel patelmosam294@gmail.com <p><strong>Background:</strong> In spite of the fact that a history of first-trimester recurrent spontaneous abortion (FRSA) is regarded as a risk factor in antenatal care, the characteristic of consequent pregnancy outcome isn’t clearly illustrated.</p> <p><strong>Methods:</strong> A prospective observational analysis was performed on the clinical data of 100 singleton pregnant women.</p> <p><strong>Results:</strong> For maternal outcomes, patients within study group delivered prior with mean gestational age and the incidences of Caesarean section and postpartum haemorrhage were higher. For placental outcomes, the incidence of placenta-mediated pregnancy complications (PMPC) within study group increased in terms of late-onset preeclampsia, oligohydramnios, early-onset fetal growth restriction, and second-trimester abortion. For perinatal outcomes, the proportion of birth abandons of newborns within study group was even higher. At last, logistic regression analyses appeared that the history of FRSA was an autonomous risk factor for caesarean section and pregnancy complications.</p> <p><strong>Conclusions:</strong> Women with the history of FRSA are often exposed to an elevated incidence of maternal-placental-perinatal adverse pregnancy outcomes.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14035 Diagnosis and management of cases of ectopic pregnancy in a tertiary care centre: our experience 2024-03-17T18:43:13+0530 Anushka S. Mehta anushka18mehta@gmail.com Riya R. Patel anushka18mehta@gmail.com Parav D. Shah paravshah9@gmail.com <p><strong>Background:</strong> Ectopic pregnancy is a leading cause of maternal morbidity and mortality. With our study, we aim to highlight the importance of risk factors and effect of clinical presentation on the management modalities of ectopic pregnancy and study changing trends of modern management from radical surgical methods to medical and laparoscopic management of ectopic pregnancies.</p> <p><strong>Methods:</strong> This prospective study was undertaken at a tertiary care hospital between May 2021 and May 2022.</p> <p><strong>Results:</strong> The most common age group of presentation was 26-30 years. The most common risk factor was history of previous abortion. Amenorrhoea and abdominal pain were the most commonly encountered symptoms in this study. Cervical motion tenderness was significantly associated with ruptured ectopic pregnancy. Conservative medical management with injection methotrexate (Mtx), which was successful in 50% cases. Success rate was 100% for laparoscopic management and 100% for laparotomy in this study. No maternal mortality was observed during the present study.</p> <p><strong>Conclusions:</strong> Our hospital being a tertiary centre, had to manage a number of cases as surgical emergencies by laparotomy and not conservatively, as they brought in either diagnosed cases of ruptured ectopic pregnancy, or failure of medical management. It is important that in the face of this diagnostic dilemma, all physicians should be should maintain a high level of suspicion and be sensitive to the fact that in the reproductive age group any woman presenting with pain in the lower abdomen, diagnosis of ectopic pregnancy should be considered irrespective of the presence or absence of amenorrhea or tubal sterilisation.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14040 Ectopic pregnancies at a tertiary care centre: a five-year retrospective study 2024-03-19T12:01:47+0530 Shamrao Ramji Wakode sharmasakshi979900@gmail.com Sakshi Pramod Sharma sharmasakshi979900@gmail.com <p><strong>Background:</strong> Ectopic Pregnancy results in significant morbidity. Our aim during present study was to understand age wise, parity wise distribution of cases, risk factors, clinical presentation and management of ectopic pregnancy which may be useful in lowering morbidity and mortality.</p> <p><strong>Methods:</strong> A five-year retrospective study was done from 2019 to 2023; comprising detailed medical records of detected cases of ectopic pregnancies admitted to the tertiary care centre.</p> <p><strong>Results:</strong> Incidence of ectopic pregnancy during present study was 0.40%. 65.48% of ectopic pregnancy cases recorded in the age group of 21-30 years. Majority of parity wise cases were multipara (63.95%). There were no risk factors noted in 34.01% cases. Majority of the cases (65.95%) had one or the other distinguishable risk factor. 21.68% cases had history of Tubectomy, while 19.38% ectopic gestation had history of abortion. Most of the patients presented with clinical presentation of amenorrhoea 59.89%. 55.83% cases had bleeding per vaginum, while 47.71% had pain in abdomen. Most common ectopic pregnancy site was ampulla, with 63.95% cases. Ultrasonic findings showed ruptured ectopic pregnancy in 59.39% cases and unruptured in 30.45%. Regarding mode of management in the cases, surgical management with unilateral total salpingectomy (56.79%) was most commonly performed, followed by salpingoopherectomy (14.81%).</p> <p><strong>Conclusions:</strong> Ectopic pregnancy is a common obstetric emergency leading to first trimester morbidity and mortality. Diagnosis of these cases requires a high index of clinical suspicion and early intervention often is lifesaving. Hence, knowledge of the disease related trends and timely management is the key for successful outcomes in such cases.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14044 The study of the correlation between international ovarian tumour analysis classification, risk of malignancy index and clinicopathological findings of adnexal masses 2024-03-21T14:02:52+0530 Mahadev Kelagade mahadevkelagade@gmail.com Ruchi N. Thakur mahadevkelagade@gmail.com Sonali Deshmukh mahadevkelagade@gmail.com <p><strong>Background:</strong> Adnexal masses of ovarian origin are of growing concern these days due to high fatality associated with ovarian malignancy because they are diagnosed at advanced stage due to vague symptoms and absence of recommended screening tests. The present study aimed to assess the prediction potential of IOTA classification and RMI to clinicopathological findings of adnexal masses and calculate the sensitivity and specificity of same.</p> <p><strong>Methods:</strong> This was a prospective observational study carried out on 96 non pregnant women presenting with adnexal mass to gynaecology OPD of a tertiary care hospital from 2020 to 2022. They were evaluated preoperatively with complete history, examination, ultrasound, and tumor markers. IOTA score and RMI was calculated for all patients. Following surgery, histopathology results were compared with preoperative evaluation. Statistical Analysis was done.</p> <p><strong>Results:</strong> Mucinous cyst adenoma was the most common benign ovarian tumour, serous cystadenocarcinoma being the most common malignant ovarian tumour. Patients with malignancy were older and mostly postmenopausal. IOTA was found better than RMI with higher sensitivity 98.5% and high PPV 98.5%. Similarly, IOTA had higher specificity 91.7% and higher NPV 91.7% for identifying and prediction of benign patients.</p> <p><strong>Conclusions:</strong> IOTA guidelines to describe sonographic features of adnexal masses have shown a high sensitivity and specificity for prediction of malignancy in adnexal masses and is a more reliable diagnostic tool over RMI tool for differentiation between benign and malignant adnexal masses.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14052 Evaluating the efficacy of metal suction cannula for atonic postpartum haemorrhage management in rural south Gujarat: a two-year observational study 2024-03-24T11:49:48+0530 Ritika Shrivastav drritikashrivastav1004@gmail.com Rekha Shrivastava rekha0369@gmail.com <p><strong>Background: </strong>In resource-constrained regions characterized by limited healthcare infrastructure, low female literacy rates, and constrained access to medical resources, postpartum hemorrhage (PPH) remains a dire obstetric emergency. This research article investigates the effectiveness of metal suction cannula as a simple, safe and cost-effective technique for atonic PPH management in a private hospital in Rural South Gujarat. The primary aim of this study was to examine the effectiveness of the metal suction cannula in managing atonic PPH and the maternal outcome after suction technique.</p> <p><strong>Methods: </strong>This observational study was conducted in Shreeji hospital, a private multifacility hospital in rural south Gujarat over the period of two years, between June 2021-May 2023 and involved 148 patients who were admitted for labour and delivery but later developed atonic PPH after AMTSL. Metal cannula and high vacuum suction machine was used. Data like patient demographics, risk factors, and post-procedural outcomes were studied.</p> <p><strong>Results: </strong>Following application of the metal vacuum cannula technique, bleeding stopped within five minutes in 78 women (52.7%). For 53 women (35.8%), bleeding ceased between 5-10 minutes. In 17 women (11.4%), bleeding was effectively halted after more than ten minutes. In 87 women (58.8%), negative pressure was applied only once, resulting in successful hemorrhage control. 38 women (25.6%) required suction application two times and 25 women (20.8%) needed three applications of negative pressure to effectively stop the bleeding. The volume of blood collected in the bottle after metal vacuum cannula application ranged from 100 to 300 ml.</p> <p><strong>Conclusions:</strong> Factors such as ease of use, affordability, and improved clinical outcomes make suction cannulas an effective tool in the management of PPH in resource limited areas. It requires minimal training, conserves the uterus, is technically less challenging and reduces the requirement of blood and blood products.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14053 Assessing contraceptive knowledge and usage among currently married women in Mizoram 2024-03-24T18:37:16+0530 N. Pautunthang naulakzomi@googlemail.com <p><strong>Background:</strong> Limited research on the issue of contraception in Mizoram prompted this study to assess contraceptive knowledge and usage among currently married women aged 15-49 using data from the national family health survey (NFHS).</p> <p><strong>Methods:</strong> Univariate and bivariate analysis was performed using SPSS-25 to analyse the NFHS data from Mizoram, focussing on the levels and trends in contraceptive knowledge and usage among currently married women aged 15-49 in Mizoram with selected background characteristics.</p> <p><strong>Results:</strong> Findings reveal a notable disparity between contraceptive knowledge (99.5%) and its actual usage (31.2%) among currently married women aged 15-49 in Mizoram. The contraceptive usage among currently married women aged 15-49 has declined from 59.9 per cent in 2005-06 to 31.2 per cent in 2019-21. Modern contraceptive methods are preferred over traditional ones, with female sterilisation being the most common method. Male sterilisation (vasectomy) is almost non-existent. District-level disparities exist, with the Aizawl district at 21.6 per cent and the Champhai district at 50 per cent contraceptive usage, according to NFHS-5 (2019-21). Factors influencing contraceptive usage include place of residence, educational level, and number of children. Unmet needs for contraception decreased between 2015-16 and 2019-21.</p> <p><strong>Conclusions:</strong> The study highlights the urgent need for interventions to bridge the gap between contraceptive knowledge and usage among currently married women aged 15-49 in Mizoram. Efforts should focus on promoting modern contraceptive methods addressing district-level disparities. Additionally, initiatives to reduce unmet needs, particularly for spacing methods, are crucial for improving contraceptive usage among currently married women aged 15-49 in Mizoram.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology https://www.ijrcog.org/index.php/ijrcog/article/view/14054 Study of obstetric and fetal outcomes associated with maternal perception of decreased fetal movements in third trimester 2024-03-24T19:30:20+0530 Ishaan S. Padore padoreishaan14@gmail.com Anagha A. Jinturkar padoreishaan14@gmail.com <p><strong>Background:</strong> Prevalence of decreased fetal movement in third trimester has been reported as 4-15% in various studies. Association between maternal perception of decreased fetal movement and poor perinatal outcome like fetal growth restriction, oligohydramnios, fetal distress, preterm births, fetal congenital anomalies, and stillbirth are revealed in different studies. However, decreased fetal movements may sometimes cause unnecessary anxiety to pregnant women or clinicians leading to unnecessary interventions. Keeping this background, we planned to assess the significance of decreased fetal movement perception in third trimester of pregnancy and its correlation with the perinatal outcome.</p> <p><strong>Methods:</strong> A prospective observational study was carried out at a tertiary health care center B. J. Government Medical College, Pune for a period of 12 months (October 2021-October 2022). Study included 150 mothers with decreased fetal movement in the third trimester. These mothers were monitored till delivery by Repeat fetal movement count, cardiotocography (CTG), ultrasonography (USG), biophysical profile (BPP) and Doppler studies. Mothers were investigated for identification of ante-natal risk factors and their mode of delivery was noted. APGAR score of neonates at birth, birth weight and requirement of neonatal intensive care unit (NICU) admissions were also noted.</p> <p><strong>Results:</strong> Study observed that most of these females were primi-mothers belonging to lower socio-economic class. Oligohydramnios, obesity, gestational diabetes and anemia were observed as common risk factors. Emergency caesarean section was required in one out of five cases while one fourth of these mothers delivered pre-term. Most common neonatal complication observed was intra-uterine growth restriction. Mortality rate was 2%.</p> <p><strong>Conclusions:</strong> We thus conclude that mothers with reduced fetal movements are a risk group and should be referred immediately. Overall outcome was good in these babies, when given optimum institutional care.</p> 2024-04-26T00:00:00+0530 Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology