International Journal of Reproduction, Contraception, Obstetrics and Gynecology <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 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="" target="_blank" rel="noopener"></a>, <a href="" target="_blank" rel="noopener"></a></p> <p><strong>Print ISSN:</strong> 2320-1770</p> <p><strong>Online ISSN:</strong> 2320-1789</p> <p><strong>Publisher:</strong> <a href="" 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. (PILA), which operates <a href="" target="_blank" rel="noopener">CrossRef (DOI)</a></p> <p> </p> <p><strong>Manuscript Submission</strong></p> <p>International Journal of Reproduction, Contraception, Obstetrics and Gynecology accepts manuscript submissions through <a href="" target="_blank" rel="noopener">Online Submissions</a>:</p> <p>Registration and login are required to submit manuscripts online and to check the status of current submissions.</p> <ul> <li><a href="" target="_blank" rel="noopener">Registration</a></li> <li><a href="" target="_blank" rel="noopener">Login</a></li> </ul> <p>Please check out the video on our YouTube Channel:</p> <p>Steps to register and submit a manuscript:<br /><a href="" target="_blank" rel="noopener"></a></p> <p>Problem Logging In-Clear cookies:<br /><a href="" target="_blank" rel="noopener"></a></p> <p>If you find any difficulty in online submission of your manuscript, please contact editor at <a href="" target="_blank" rel="noopener"></a>, <a href="" target="_blank" rel="noopener"></a></p> <p><strong> </strong></p> <p><strong>Abbreviation</strong></p> <p>The correct abbreviation for abstracting and indexing purposes is Int J Reprod Contracept Obstet Gynecol.</p> <p><strong> </strong></p> <p><strong>Abstracting and Indexing information</strong></p> <p>The International Journal of Reproduction, Contraception, Obstetrics and Gynecology is indexed with</p> <ul> <li><a href="[Title+Abbreviation]" target="_blank" rel="noopener">PubMed and PubMed Central (PMC)</a> ((NLM ID: 101629365, Selected citations only)</li> <li><a href="" target="_blank" rel="noopener">Index Medicus for South-East Asia Region (WHO)</a></li> <li><a href=";journalId=31376" target="_blank" rel="noopener">Index Copernicus</a> </li> <li><a title="Scilit (MDPI)" href="" target="_blank" rel="noopener">Scilit (MDPI)</a></li> <li><a href="" target="_blank" rel="noopener">ScopeMed</a></li> <li><a href="" target="_blank" rel="noopener">CrossRef</a></li> <li><a href="" target="_blank" rel="noopener">EBSCO A-to-Z</a></li> <li><a href="" target="_blank" rel="noopener">Ulrichsweb</a></li> <li><a href="" target="_blank" rel="noopener">Journal Index</a></li> <li><a href="" target="_blank" rel="noopener">Google Scholar</a></li> <li><a href="" target="_blank" rel="noopener">J-Gate</a></li> <li><a href="" target="_blank" rel="noopener">Directory of Science</a></li> <li><a href="http://localhost/index.php/ijrcog">Gale</a></li> <li><a href="" target="_blank" rel="noopener">JournalTOCs</a></li> <li><a href=";issn=23201770&amp;uid=r7704d" target="_blank" rel="noopener">ResearchBib</a></li> <li><a href="" target="_blank" rel="noopener">ICMJE</a></li> <li><a href=";fIDnum=|&amp;mode=simple&amp;letter=ALL&amp;la=en" target="_blank" rel="noopener">SHERPA/RoMEO</a></li> </ul> Medip Academy en-US International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2320-1770 Vulval leiomyoma causing coital difficulty: report of two cases <p>Leiomyoma is a smooth muscle benign tumor and it is a common benign lesion of the uterus in women of the reproductive age group with a prevalence of about 30%. Though the prevalence of uterine fibroid was 6.5% in Ile-Ife, and 8.5% of gynecological admissions in Ilesha, Nigeria, vulval leiomyoma is very rare and often misdiagnosed as Bartholin cyst or with other differentials like lipoma, etc. It is usually not considered a differential of vulval masses, but with detailed examination and with the use of investigative tools, the diagnosis can become clearer. This paper presents 2 cases of histologically diagnosed vulval leiomyoma seen at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) between January 2017 and December 2021 with both patients complaining of coital difficulty. During this time, the prevalence of this lesion was calculated to be 0.092% of gynecology admissions and 0.17% of gynecological surgeries done in the hospital.</p> Olufemi A. Solaja Olusola B. Fasubaa Olusegun K. Ajenifuja Clement A. Adepiti Nife O. Adedeji Adeyemi A. Adefidipe Solomon O. Ayodele Augustine B. Ndiwe Oluwasola A. Solaja Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1038 1041 10.18203/2320-1770.ijrcog20240809 Conjoined twin parapagus dicephalus <p>A multi-fetus pregnancy occurs when there are two or more embryos or fetuses present at once. The most obvious anatomical position of the fusion of the fetal components can be used to classify conjoined twins, a rare congenital abnormality with an incidence of 1.5 per 100,000 births. A 29-year-old multiparous pregnant woman came to Arifin Achmad hospital, Pekanbaru, Riau. The patient received a referral from an obstetrician because there was a foetal abnormality. The patient did not have any complaints when he came to the hospital. The results of the ultrasound examination showed that the intrauterine Gemelli foetus was alive and had conjoined twins (parapagus-dicephalus). There are 2 pairs of legs, 2 pairs of hands, 2 heads, and 2 hearts. The patient was then planned for abdominal termination of pregnancy. A caesarean operation was performed, and a baby boy was born with 2 heads, 4 arms, 2 hearts, and 2 legs. With the baby's birth weight of 4200 gm, birth length of 47 cm, and Apgar score of 7/8, anal atresia was also found in the fetus. Pregnancy with multiple fetuses carries a high risk of maternal and perinatal morbidity and mortality. The risk of complications for both the mother and the child must be reduced by the early diagnosis of multi-fetus pregnancies with conjoined twins.</p> Edy Fakhrizal Nola Yolanda Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1042 1044 10.18203/2320-1770.ijrcog20240810 A case of ovarian juvenile granulosa cells tumor with peritoneal and jejunal localisation at Amath Dansokho Regional Hospital, Kedougou, Senegal <p>Granulosa tumors are rare ovarian tumors they belong to sex-cord and stromal tumor family. They are the most common type of malignant stromal tumor and have a good prognosis. There are two types: the adult type (AGCTs), which occurs most frequently between the ages of 40 and 70, and the juvenile type (JGCTs), which is uncommon. Juvenile granulosa tumors tend to involve a single ovary and occur mainly in people who are younger than 30 years. Metastatic spread is rare and, if present, is usually limited to the peritoneal cavity. We report a case of ovarian juvenile granulosa cell tumor extending to the jejunum and peritoneum in an 18-year-old female patient received in our institution.</p> Mouhamadou Wade Thierno A. T. Diallo Foulaké Tandian Nankouma Konate Abdoulaye Keita Alfred N. Sarr Ousmane Diop Doudou Sane Khadim Faye Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1045 1047 10.18203/2320-1770.ijrcog20240811 Challenging myomectomy of large cervical fibroid - successful fertility outcome: a case report <p>The cervical fibroids are rare and large cervical fibroids are rarer. Removing large cervical fibroids when a patient desires future fertility is a surgical challenge because of the risks of significant blood loss, bladder and ureteric injury, and unplanned hysterectomy. For women who desire future fertility, myomectomy can improve the chances of pregnancy by restoring normal anatomy. In this article, we describe a successful pregnancy following the restoration of the normal anatomy of the cervix by a challenging myomectomy in a sub-fertile patient with a large cervical fibroid. A 38-year-old nulliparous lady presented to the reproductive endocrinology and infertility (REI) department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh with primary sub-fertility for five and half years, and dysmenorrhea for 2 years. She was a regularly menstruating woman with average flow and duration. Being a resident of Canada, she was diagnosed there as a case of large cervical fibroid (10×9 cm) by TVS extending up to the posterior wall of the uterus, cervix, and upper vagina impacted in the pouch of Douglas during infertility workup. For this reason, she was advised for in vitro fertilization (IVF) keeping the fibroid in situ. However, due to the failure of embryo transfer with this large cervical fibroid, she was advised for embryo transfer following myomectomy. Hysteroscopic myomectomy was tried first (in February 2019 in Canada) but was unable to be removed. Then Laparotomy was tried (in September 2019 in Canada) but failed again. Being a complicated case, she was counselled there for myomectomy by a multidisciplinary approach with the high risk of injury to the urinary bladder, ureter, bowel, and other pelvic structures. But she refused to do a myomectomy there after knowing the dreadful complications with the fear of injury to the pelvic organs. With this problem, she went to different institutions both in the country and abroad but couldn’t get the proper treatment. Finally, she visited the outpatient department (OPD) of the REI department, BSMMU, Dhaka, Bangladesh with the hope of getting the most appropriate treatment for her and she was reassured, counselled, and managed by a challenging myomectomy (in March 2022) through a combined approach of the vagina and abdominal route without any significant intra and post-operative complications. Her whole post-operative period was uneventful, the anatomy of the cervix was restored and detected by TVS, and trial transfer was done before embryo transfer with easy negotiation to the cervix. Finally, she conceived 1 year after myomectomy with easy frozen embryo transfer. Myomectomy in expert hand even for the large cervical fibroid can restore normal anatomy and can achieve successful pregnancy outcomes.</p> Jesmine Banu Mostafa M. Altarique Rebeka Sultana Nastaran Lasker S. M. Munira Shaheen A. Anwary Ariful Islam Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1048 1051 10.18203/2320-1770.ijrcog20240812 Torsion of ovary and acute abdomen <p>Ovarian torsion refers to partial or complete rotation of ovarian vascular pedicle. This study explored the presenting symptoms and management of ovarian torsion in a newly established ESIC Medical College and Hospital, Bihta, Patna. This report presents two cases of ovarian torsion, the presenting symptoms and management. This underscores the need of prompt diagnosis and management to improve postoperative outcomes.</p> Suvidha Saurabh Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-14 2024-03-14 13 4 1052 1054 10.18203/2320-1770.ijrcog20240680 Operative hysteroscopy assisted evacuation of a non-viable pregnancy in the setting of a congenital uterine anomaly - bicornuate bicollis <p>The uterus is formed during embryogenesis by the fusion of the two paramesonephric ducts (mullerian ducts). The two mullerian ducts normally fuse to form the single uterine body. A didelphis uterus will have a double cervix and a double vagina. This case report describes the successful removal of retained products of conception following a spontaneous miscarriage in the setting of a bicornuate bicollis anomaly with a non-viable pregnancy using operative hysteroscopy. The successful removal of the retained products of conception is an essential step in the management of a spontaneous miscarriage. Gynaecologists should be aware of the potential complications associated with this condition and refer patients with a diagnosis of uterine didelphys to an expert in gynaecology for further evaluation and management.</p> Sonam Simpatwar Beena Kumari Avani Bhardwaj Munazza Afreen Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1055 1057 10.18203/2320-1770.ijrcog20240813 A rare case of advanced abdominal pregnancy with good maternal and fetal outcome <p>Advanced abdominal pregnancy is an uncommon and potentially precarious variant of ectopic pregnancy in which the fetus develops in the abdominal cavity. A 30-year-old multigravida presented at 33+5 weeks of gestation with abdominal pain. Ultrasonography revealed a single live fetus lying in the abdominal cavity, with the uterus seen separately. Previous ultrasonography done at 15 weeks of gestation was suggestive of intrauterine pregnancy. She underwent emergency laparotomy at 33+6 weeks, which confirmed secondary abdominal pregnancy with the placenta deriving its blood supply from the left uterine artery and omental vessels. A peripartum hysterectomy was performed. The postoperative period was uneventful, and both mother and baby were discharged after one week. Despite notable advancements in prenatal care and medical imaging technologies, abdominal pregnancies, even if advanced, may remain undiagnosed, emphasizing the necessity for healthcare professionals to maintain a heightened level of suspicion regarding this condition. If conservative management has to be sought, the case selection should be done carefully due to the high risk to both the mother’s and fetus’s life. There is a pressing need for the standardisation of treatment protocols in order to optimise maternal and fetal outcomes in abdominal pregnancy.</p> Akanksha Agarwal Ramandeep Bansal Pooja Sikka Tanvi Katoch Nalini Gupta Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1058 1060 10.18203/2320-1770.ijrcog20240814 Multiple lipoleiomyoma of the uterine cervix in premenopausal woman: a case report <p>Leiomyoma is a most frequently occurring benign mesenchymal tumor of monoclonal origin arising from the smooth muscle cells of the uterus. There are different subtypes of leiomyoma based on their morphological features. Lipoleiomyoma is a rare distinct variant of leiomyoma with a heterogenous cut surface comprising soft yellow areas of fatty tissue intermixed with firm rubbery areas of smooth muscle tissue. We report a case of a 35-year-old multipara premenopausal woman who presented with abdominal distension and chronic pelvic pain. Clinical examination gave an initial impression of a teratoma. Multiple large heterogenic cervical masses of varying sizes were noted on ultrasonography. Histopathological examination of the surgical resection specimen revealed multiple mature lipoleiomyomas. This case report is unique due to its occurrence in premenopausal women and its location in the cervix.</p> Smita Singh Rakesh Kumar Divya Jyoti Kiran Agarwal Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1061 1063 10.18203/2320-1770.ijrcog20240815 Case of ovarian torsion-detorsion-ovarian and round ligament plication to save the ovary <p>Adnexal torsion is defined as twisting of the ovary and/or tube around usually the utero-ovarian ligament and in case of the ovary the infundibulopelvic ligament. Ovarian torsion is seen in reproductive age group, mainly due to enlongated ovarian ligament. Recurrence is more uncommon. This article presents a case of young 23-year-old women presenting with acute pain abdomen, with scan showing ovarian torsion, an emergency laparoscopy was performed, 1 turn of left infundibulopelvic ligament was noted and detorsion performed along with plication of round and ovarian ligament and utero-ovarian ligament plication. This helps in preventing recurrent ovarian torsion, though there is no standard management to prevent recurrent ovarian torsion, plications to some extent prevents recurrent torsion and thus also preserving fertility of women.</p> Mahendra Gangadharaiah Sunil Chikkatharahalli Vykuntegowda Vijayalaxmi Tejashwini A. Neelavani Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1064 1066 10.18203/2320-1770.ijrcog20240816 Unveiling the uncommon: invasive adenocarcinoma cervix presenting during pregnancy: a rare case report <p>Adenocarcinoma of the cervix presenting during pregnancy is an exceedingly rare occurrence, and the optimal management approach remains uncertain due to limited reported cases. Here we are presenting a case of a multiparous lady who presented with complaints of amenorrhoea for 3 months, pain abdomen, spotting per vaginum, mass felt per vaginum. Ultrasonography showed single live intrauterine pregnancy at 11 weeks 4 days of gestational age with an ill-defined hyperechoic lesion measuring 4.36×4.92×4.16 cm in cervix. HPE of cervical biopsy confirmed cervical adenocarcinoma-endocervical type, grade 2. On MRI, a heterogeneous exophytic irregular mass involving the external os, protruding into the upper vaginal cavity was identified with infiltration into the anterior upper vaginal wall, pelvic lymphadenopathy, and sub-centimetric inguinal lymph nodes were observed. The patient underwent radical hysterectomy with bilateral pelvic lymph node dissection. The surgical specimen exhibited stromal invasion exceeding 5mm in depth and width greater than 7mm, involving entire cervical wall with lympho-vascular space invasion. The tumor was ER/PR negative, strongly positive for P16, and HPV studies were also positive. Adjuvant external beam radiotherapy (EBRT) was administered to the pelvis, and the patient is currently in remission.</p> Sheral R. Tauro Yanglem A. Singh Basanti Namoijam Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1067 1070 10.18203/2320-1770.ijrcog20240817 Mayer-Rokitansky-Küster-Hauser syndrome type II: a case report and literature review <p>Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a genetic disease consisting of absent uterus and upper part of vagina, and is seen in women with a normal karyotype (46, XX). It is one of the rare diseases where the estimated prevalence is 1:5000. Most patients present with primary amenorrhea at a young age, with or without bone or kidney abnormalities. The associated psychological aspects of this disease often enforce the need for a prompt diagnosis and treatment. The preferred method for preoperative evaluation of these patients is magnetic resonance imaging (MRI).</p> <p> </p> Nirupam K. Baishya Kakoli Baishya Jyotishmita Pathak Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1071 1074 10.18203/2320-1770.ijrcog20240818 An unusual case of chronic ectopic pregnancy <p>Thirty-seven years old P3A1L3 patient presented to our outpatient department with pain abdomen for 20 days. Thirty-five days back she had taken MTP kit and then after one week, D&amp;C was done at a primary care centre, presuming incomplete abortion. After this, she developed abdominal distension and couldn’t pass motions. Then she went to some other health care centre and few investigations were done, there. USG showed bulky, excessively enlarged uterus with echogenic material in endometrium, Molar pregnancy, Endometrial mass, Left sided grade 2 hydronephrosis. After exploratory laparotomy, left sided salpingectomy was done. Histopathology report was consistent with ectopic pregnancy.</p> Anima Prasad Amrish Kumar Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1075 1078 10.18203/2320-1770.ijrcog20240819 Endodermal sinus tumor of ovary with metastasis from breast carcinoma: a case report <p>Endodermal sinus tumor is malignant germ cell tumor of ovary. Endodermal sinus tumours (EST) also know as yolk sac tumor are rare about 1% of ovarian malignancies and highly malignant tumours occurring primarily in children and young women. Overall survival is poor. In present case patient was breast cancer survivor and completed her treatment for breast cancer 10 years back. Later on she developed rapidly growing bilateral ovarian mass. Tumor markers of epithelial ovarian tumor were raised. Gross examination was suggestive of Krukenberg tumor and on histopathological examination that was suggestive of endodermal sinus tumor, Finally, Immunohistochemistry helped to conclude the diagnosis of metastatic ovarian tumor from breast carcinoma.</p> Chandni Nirbhay Kumar Bind Neeta Meena Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1079 1081 10.18203/2320-1770.ijrcog20240820 Breast tuberculosis: a case series <p>Tuberculosis is one of the leading infectious and contagious diseases, caused by bacteria belonging to the Mycobacterium family. Breast involvement ranks last among the extrapulmonary manifestations of tuberculosis but remains an important clinical condition that may present clinical and radiological similarities with breast cancer, thus requiring a thorough diagnostic approach including histological and/or bacteriological confirmation. This is a retrospective study conducted at the department of Gynecology and Obstetrics of the Military Hospital Moulay Ismail - Meknes, over a period of 4 years. A total of 6 cases of breast tuberculosis were observed, resulting in an incidence rate of 6 cases per 7600 women-years. The mean age of patients was 39 years. Signs of tuberculosis impregnation were found in 33% of cases. The clinical forms encountered, in descending order of frequency, were: diffuse form (50% of cases), nodular form (33% of cases), and sclerotic form (16% of cases). The radiological findings were almost always suggestive of a suspicious lesion. Diagnosis was primarily based on the histopathological study of breast biopsy. All our patients received a standard regimen of anti-tubercular treatment including: 4 months of Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol followed by 2 months of Rifampicin and Isoniazid with favorable outcomes. Only one patient experienced a recurrence due to under dosing of Rifampicin, which was managed with a total of 9 months of treatment. One patient underwent additional surgical drainage. Early and thorough diagnosis of breast tuberculosis is crucial as it helps avoid mutilating surgery in often young women.</p> Mounir Moukit Youssef Bougrini Mohammed Rahmoune Ismail Allilou Abdellah Babahabib Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1013 1019 10.18203/2320-1770.ijrcog20240805 The compression of myometrium and occlusion of uterine artery by COMOC-MG technique for the management of postpartum haemorrhage: clinical perspective from ten cases <p>Compression of myometrium and occlusion of uterine artery by Dr. Mahesh Gupta (COMOC-MG) technique is an improved B-lynch stitch technique used to control postpartum hemorrhage (PPH). Objective was to study clinical perspective of the COMOC-MG technique on the effect of PPH in Indian women. Data of 10 patients with PPH who were managed by using the COMOC-MG technique in a tertiary care center in Gujarat from April 2022 to December 2022 were retrieved. Baseline characteristics, medical problems and history of women were recorded. Decision to perform COMOC-MG stitch was taken based on the indications such as PPH, per vaginal bleeding and degree of uterine contractility. Out of 10 women, four women had medical problems such as pregnancy-induced hypertension, dysfunctional uterine bleeding and using psychiatric medicines; two women had uterine surgery/ Laparotomy; four women were diagnosed with ailments such as pregnancy induced hypertension (PIH) and hypertension during the third trimester of pregnancy. Indications such as twins during a previous pregnancy, deflexed head, previous lower segment caesarean section (LSCS) with intrauterine growth restriction (IUGR), breech, prim parity, severe oligohydramnios, placental insufficiency and second baby were considered to carry out the CS delivery. Women were managed by COMOC-MG stitch followed by Misoprostol tablets; Carbetocin, Oxytocin, Methylergometrine and Carboprost injections to control PPH. Mean time between uterine closure to COMOC-MG was 10 min. COMOC-MG stitch resulted in good outcomes in seven patients except one patient had atonic PPH. Out of ten patients, one patient required a hysterectomy and three patients required blood transfusion. COMOC-MG stitch is an easy, simple method to control PPH.</p> Jitendra Prajapati Abhishek Oza Mahesh Gupta Ketan Kulkarni Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1020 1024 10.18203/2320-1770.ijrcog20240806 Diagnostic evaluations and management of surgical scar endometriosis: a case series of 13 cases over 9 years <p>Endometriosis is defined as localization of ectopic functional endometrial gland and stroma. Scar endometriosis is a rare benign gynecological disease affecting women in the reproductive age group. It’s incidence in post-caesarean and post-hysterotomy scar tissue is approximately 0.03-0.4% and 1.08-2% respectively. This case series reviews literature of medical data of 13 patients who presented over 9 years with incisional site endometrioma, diagnostic approaches and treatment is discussed. The patients presented in 2<sup>nd</sup> to 3<sup>rd</sup> decade of life with complaints of cyclical pain and mass at previous surgery scar. Ultrasonography (USG) detected hypoechoic mass/granuloma and inconclusive in most cases. Magnetic resonance imaging (MRI) though was suggestive of diagnosis in almost all cases. Definitive diagnosis was histopathological examination. Treatment was achieved with surgical excision in all patients, and 3 are preceded by hormonal treatment. Medical treatment can only yield symptomatic relief in pain till the hormone effect lasts. Treatment of choice is wide excision that is excision of 1 cm tissue around the mass. Endometriosis in operative site scar tissue may present as a discrete mass which may be painful and can be confused clinically with a variety of surgical conditions. It is extremely important to recognize the condition so as to avoid potential clinical pitfalls in the diagnosis of this treatable entity.</p> Jamuna Kanakaraya S. Kanakaraya Chandrahasa Avni Bhardwaj Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1025 1032 10.18203/2320-1770.ijrcog20240807 Comparative study between vaginal sacrospinous ligament fixation with abdominal sacrocolpopexy <p>Vaginal vault prolapse is about 4-6 per 1000 but it is increasing with increase in life expectancy with more number of years in menopausal age. It is not a common condition following abdominal and vaginal hysterectomy. It has a negative impact on the quality of life of women due to incontinence of urine, irregular defecation symptoms and sexual dysfunction along with psychosocial problems. This study compares the efficacy of most two successful surgeries which were done by abdominal and vaginal route for correcting post hysterectomy vault prolapse by postoperative assessment and at least 6 to 12 months follow up. This is the retrospective case series among post hysterectomy women attending the Gynae OPD in SVBP hospital associated with LLRM medical college Meerut from January 2022 to January 2023. Study population included 19 women divided into two groups; group 1 includes 8 women who underwent unilateral sacrospinous ligament fixation and group 2 includes 11 women who underwent abdominal sacrocolpopexy. In demographic and clinical features between the two groups, there is no statistically difference found in terms of mean age, mean weight, mean BMI and mean parity. Hence, both groups are comparable. The operating time is longer in ASC (85.90±40.23 minutes) group when compared to SSF group (43.43±6.9 minutes) (p value= 0.00096), blood loss reported in ASC (341.72±37.14 ml) slightly more than in SSF group (237.5±32.84 ml) (p value= 0.0001) and mean hospital stay is longer in ASC (6±5.1 days) than SSF group (3.2±0.9 days) (p value=0.0001). Other complications like postoperative pyrexia, wound infection, urinary complaints were higher in ASC group and at follow up, the mean vaginal length was longer in ASC (6.9±0.8 cm) then SSF (5.2±0.8cm) group (p value=0.0005). We concluded that as the ultimate aim of vault prolapse surgery is to improve the function and restoring anatomy and to improve the quality of life, in that respect, both abdominal sacrocolpopexy and sacrospinous ligament fixation both are effective methods and less complications are noted in SSF group. It also depends on the hands of an expert, though recovery time is faster in SSF than ASC group.</p> Renu Chaudhary Shakun Singh Anupam Rani Rachna Chaudhary Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1033 1037 10.18203/2320-1770.ijrcog20240808 Human papillomavirus genotype distribution among colposcopy diagnosed cervical precancerous lesions <p><strong>Background:</strong> Cervical cancer (CC) is one of the primary causes of gynaecological cancer death. Cervical cancer is the fourth most frequent cancer worldwide, and it is the second most common cancer in Bangladesh. The stage of cervical cancer at diagnosis has a significant impact on survival. Cervical cancer mortality is high in Bangladesh due to late detection and limited management facilities. The aim of the study was to determine the pattern of human papillomavirus (HPV) genotype among colposcopy diagnosed cervical precancerous lesions.</p> <p><strong>Methods:</strong> This cross-sectional study was conducted in the department of gynecological oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka. Total of 142 women attending the colposcopy clinic of BSMMU.</p> <p><strong>Results:</strong> The mean age was found 38.7±7.3 years with a range from 30 to 60 years. 10 (7.0%) patients were found HPV 16 positive followed by 1 (0.7%) HPV 18, another hr-HPV 3 (2.1%), HPV 16 and other hr-HPV 3 (2.1%) and HPV 16, HPV 18 and other hr-HPV 1 (0.7%). Regarding colposcopy reports 99 (69.7%) patients had CIN I, 33 (23.7%) had CIN II and 10 (7.0%) had CIN III identification by colposcopy reports. 61 (43.0%) patients had CIN I followed by 15 (10.6%) had CIN II, 11 (7.7%) had CIN III, 7 (4.9%) had CIS, and 48 (33.8%) had normal or squamous metaplasia by histopathological reports.</p> <p><strong>Conclusions:</strong> It can be concluded that among all the 14 hr-HPV genotype HPV 16 is more prevalent while HPV18 prevalence was very low in colposcopy diagnosed cervical precancer cases. The study revealed HPV16 was more common among high grade lesions.</p> Fahmida Sultana Mishkat Tabassum M. Jakanta Faika Anamica Dev Kazi S. Haque Mossa N. Aktar Shah N. Sharmin Ashrafun Nessa Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 791 796 10.18203/2320-1770.ijrcog20240767 Insight in the consistency of care pathway of patients newly diagnosed with stage 1A1 cervical cancer <p><strong>Background:</strong> This study aimed to assess the consistency of care pathway in patients diagnosed with stage 1A1 cervical cancer in our hospital.</p> <p><strong>Methods:</strong> Retrospective analysis of care pathway of patients with stage 1A1 cervical cancer over the last 5years 2017-2022 by accessing their electronic records. Data collected were, information given to patients and their GP of cancer diagnosis, access to clinical nurse specialist, patient information leaflet, Multidisciplinary Team review, discussion of treatment following primary LLETZ and follow up.</p> <p><strong>Results:</strong> Total 45 patients were diagnosed with stage 1A1 cervical cancer. All patients and their GPs were sent letters about their diagnosis and plan for further management after multidisciplinary team discussion. Access to clinical nurse specialists noted in 16, and provision of patient information leaflet noted in 9 patient records. Regarding treatment 14 patients had a repeat LLETZ, 7 patients underwent hysterectomy, 5 patients had a second LLETZ procedure followed by hysterectomy and 19 had routine follow up (colposcopy and cervical smear). Follow up of the 33 patients who had LLETZ as definitive treatment, 1patient had recurrence of cancer and 2 patients had low grade dyskaryosis. Histology post hysterectomy, 5 patients had no evidence of CIN, 6 patients showed CIN with complete excision, and no cases of CIN with incomplete excision. All vault smears were negative for malignancy.</p> <p><strong>Conclusions:</strong> The clinical standards of management were in par with expectations, however, to improve unmet holistic needs (access to information of support groups, clinical nurse specialists, patient information leaflets).</p> Sujjanna A. L. Manuel David Nunns Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 797 802 10.18203/2320-1770.ijrcog20240768 Utility in the obstetric high dependency unit and intensive care unit in tertiary medical center in Ethiopia: a comparative cross-sectional study <h2><a name="_Toc156381944"></a></h2> <p><strong>Background</strong><strong>:</strong> Globally, an estimated 10.7 million women have died due to obstetric complications in the last two decades, and two-thirds of these deaths occurred in sub-Saharan Africa. This study aims to assess the utility of the obstetric high dependency unit and intensive care unit and maternal outcome in a tertiary medical center in Ethiopia.</p> <p><strong>Methods:</strong> A comparative cross-sectional study was conducted on critically ill obstetric clients admitted to St. Paul's Hospital Millennium medical college obstetric HDU from October 2020 to September 2022 and before the establishment of the obstetric HDU (who were admitted to the medical ICU). Binary and multivariate logistic regression was conducted to identify factors associated with maternal mortality before the establishment of the maternal HDU.</p> <p><strong>Results:</strong> The minimum duration in both units was one day. The maximum duration was 14 days for HDU and 26 days for ICU. Following the establishment of the maternity HDU, the ICU admission rate decreased to 1.2 per 1000 deliveries. Obstetric patients diagnosed with DIC and HELLP syndrome upon admission to the ICU had a 4.9 times higher risk of mortality compared to their counterparts. Obstetric women admitted to the ICU and treated with inotropic agents or vasopressors had a 33.8 times higher risk of mortality compared to their counterparts.</p> <p><strong>Conclusions:</strong> Obstetric admissions to the ICU significantly decreased following the establishment of the maternity HDU. Obstetric patients diagnosed with DIC and HELLP syndrome are more likely to develop unfavorably outcome.</p> Assefa A. Jegora Ephrem H. Ahmed Menbeu S. Mohamed Adam D. Laytin Ayida T. Negussie Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 803 811 10.18203/2320-1770.ijrcog20240769 Maternal and perinatal outcomes in women with polycystic ovarian syndrome <p><strong>Background:</strong> Pregnant individuals with polycystic ovarian syndrome (PCOS) seem to face a heightened susceptibility to unfavorable outcomes. This investigation aimed to evaluate the consequences of pregnancies in patients diagnosed with PCOS.</p> <p><strong>Methods: </strong>This cross-sectional study involving 115 pregnant patients with PCOS was carried out at the department of obstetrics and gynecology, Dhaka medical college and hospital, Dhaka, Bangladesh, tertiary care facility, from January 2023 to December 2023. Data on the ongoing pregnancy, PCOS, and outcomes were analyzed by SPSS version 20.</p> <p><strong>Results: </strong>Average age of participants was 25.07 years. Incidence of premature rupture of membranes (PROM) was 33.91%, low APGAR score at 5 minutes was 12.17%, gestational diabetes (GDM) occurred in 23.47% of cases, miscarriage was reported in 2.1%, preterm delivery in 13.91%, cesarean delivery in 37.39%, low birth weight babies accounted for 2.6%, macrosomia occurred in 0.7%, preterm PROM (PPROM) in 19.52%, perinatal mortality 1.73%.</p> <p><strong>Conclusions:</strong> In pregnancy with PCOS, the percentage of GDM, preterm delivery, meconium-stained liquor, small for gestational age (SGA)/intrauterine growth restriction (IUGR), macrosomia, PPROM, perinatal mortality, neonatal intensive care unit (NICU) admission, and congenital anomalies were either comparable or lower. However, a higher percentage of hypertension in pregnancy, PROM, low birth weight babies, and low APGAR score at five minutes was observed in this population.</p> Luna Farhana Hoque Aklima Zakaria Zinan Suraiya Apsara Afreen Sultana Danny Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 812 816 10.18203/2320-1770.ijrcog20240770 Prevalence of menstrual disorders and self-care practices among female undergraduates in a southwestern tertiary institution, Nigeria <p><strong>Background:</strong> Menstrual health, crucial for women's well-being, often remains obscured by misconceptions, stigma, and limited awareness. This study aimed to assess menstrual disorder prevalence and self-care practices among female undergraduates.</p> <p><strong>Methods:</strong> Using a descriptive cross-sectional design, we surveyed 216 female undergraduates through a structured questionnaire, employing multistage sampling. Data underwent Chi-square and logistic regression analysis (5% CI).</p> <p><strong>Results:</strong> Dysmenorrhea (81.9%), amenorrhea (41.7%), menorrhagia (30.6%), and irregular cycles (30.5%) were predominant menstrual disorders. Self-care was practiced by many during menstruation, including pain medication (50%), heat application (38.9%), and exercise (29.2%). Nonetheless, 59.7% lacked awareness about self-care practices. Age (p&lt;0.05, OR=7.07, CI: 0.75–66.90), educational level (p&lt;0.05, OR=2.75, CI: 0.76–10.01), knowledge level (p&lt;0.05, OR=0.67, CI: 0.22–2.02), and education sponsor (p&lt;0.05, OR=3.44, CI: 0.56–21.22) were linked to menstrual disorders, highlighting the need for menstrual hygiene product access.</p> <p><strong>Conclusions:</strong> This study identified high menstrual disorder prevalence and urges awareness and education for proper self-care. Tailored interventions by policymakers, educators and healthcare providers can empower women, enhancing menstrual health outcomes.</p> Love B. Ayamolowo Sunday J. Ayamolowo Esther O. Olayinka Adekemi E. Olowokere Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 817 825 10.18203/2320-1770.ijrcog20240771 Female pelvic floor myofascial syndrome and its relationship with lower urinary tract storage symptoms <p><strong>Background</strong>: Pelvic floor myofascial syndrome is defined as non-articular skeletal muscle pain, characterized by the presence of trigger points. Present in 14-23% of patients with chronic pelvic pain. It has an impact on urinary function. The prevalence of lower urinary tract symptoms is 15-67%, with storage symptoms predominating in patients with PFMS. Objective was to determine the relationship between female pelvic floor myofascial syndrome and lower urinary tract storage symptoms.</p> <p><strong>Methods:</strong> This was a retrospective, observational, descriptive, cross-sectional, homodemic and single-center study at University Hospital Doctor José Eleuterio González, Monterrey, Nuevo Leon, Mexico from period one from April 1<sup>st</sup> to June 30<sup>th</sup>, 2022. Type of non-probabilistic convenience sampling. Database in Excel 2016, Pearson's Х² statistical test in the SPSS V25® program.</p> <p><strong>Results</strong>: 136 patients with PFMS and LUTS storage were evaluated. The most frequent age group was 46-55 years with 33.1% (N=45); the marital status was married with 74.3% (N=101). In relation to education 55.9% (N=76) with a bachelor's degree. The most frequent storage symptoms were nocturia 67.6% (N=92) p&lt;0.05, frequency 60.3% (N=82) p=0.512, urgency 57.4% p&lt;0.005.</p> <p><strong>Conclusions</strong>: Knowing the correlation between PFMS and storage LUTS can guide specific pain treatment with review of urinary symptoms. In patients with nocturia, frequency, urgency, SUI and UUI, a physical examination should be performed and included trigger points in the pelvic floor. Nocturia is the most prevalent storage LUTS in PFMS.</p> José I. Leyva Vazquez Guadalupe Guerrero Reyes Adrián Gutiérrez González Ricardo Hernández Velázquez Karen M. Loya Maldonado Omar Treviño Cavazos Jennifer E. Reyes Alcaraz Alejandra Robledo Torres Sara Y. Saca Cuevas Juan C. Herrera Morales Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 826 829 10.18203/2320-1770.ijrcog20240772 Effect of ulipristal acetate on leomyoma of uterus <p><strong>Background:</strong> The efficacy and side-effect profile of ulipristal acetate (UPA) for the treatment of symptomatic uterine fibroids before surgery are unclear. Main objective of the study to see the effect of UPA on leomyoma.</p> <p><strong>Methods:</strong> An observational clinical trial was conducted at the department of gynaecology and obstetrics, Sir Salimullah medical college and Mitford hospital, Dhaka, from January to June 2015. Thirty women aged 18-48 with symptomatic fibroid uterus were studied. They received Tablet UPA 5 mg/day for 3 months. Evaluation included history taking, physical examination, pelvic ultrasonography, and necessary investigations.</p> <p><strong>Results:</strong> The majority of patients (43.3%) were ≤30 years old. Before intervention, heavy bleeding was observed in all patients until the 8<sup>th</sup> day of menstruation. During intervention, majority had no bleeding from the 5<sup>th</sup> to 8<sup>th</sup> day, with only a few experiencing heavy bleeding on the 7<sup>th</sup> and 8<sup>th</sup> day. After intervention, most patients had no bleeding from the 5<sup>th</sup> to 8<sup>th</sup> day, with a few reporting spotting on the 5<sup>th</sup> day. Before treatment, 60% had fibroid size &gt;10 cm<sup>2</sup>. After treatment, 92.3% had fibroid size &lt;10 cm<sup>2</sup>, with 7.7% showing no fibroids. Mean uterine size decreased post-treatment. Majority (57.7%) had hemoglobin &gt;11 gm/dl. Side effects included headache (11.5%), hot flashes (15.4%), and nausea/vertigo (19.2%). Treatment success rate was 86.7%.</p> <p><strong>Conclusions:</strong> In a group of selected patients with fibroid uterus and heavy menstrual bleeding, UPA (5 mg/day for 3 months) successfully decreases blood loss and shrinks fibroid and uterine size by 86.7%.</p> Roksana Akter Ferdousi Begum M. Abdul Alim Nahid Binte Rahim Shadia Azmain Rasna Tasnim Rahman Khaleda Ferdous Kamrun Nahar Liza Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 830 836 10.18203/2320-1770.ijrcog20240773 Evaluation of the effects of epidural labour analgesia on mode of delivery <p><strong>Background:</strong> Epidural analgesia is the most effective method of pain relief during labour and the only method that provides complete analgesia without maternal or foetal adverse effects. This study aimed to assess the mode of delivery outcomes of labour in women who had received effective epidural analgesia.</p> <p><strong>Methods:</strong> After ethical approval, this quasi-experimental study was carried out in Dhaka Medical College Hospital for one year, from July 2021 to June 2022. A total of 100 admitted pregnant women (37 weeks to 41 weeks) in the labour ward were included in the study according to the inclusion and exclusion criteria. Among them, 50 women were in group A (with epidural analgesia), and the other 50 were in group B (without epidural analgesia). A detailed history and thorough clinical examination were carried out on each patient. Data were collected in separate case-record forms and analyzed using SPSS 24.</p> <p><strong>Results: </strong>Mean age, gestational age, parity, and body mass index were statistically similar in both group A and B. Normal vaginal delivery rate (86% vs. 90%), instrumental delivery rate (10% vs. 6%), and caesarean section rate (4% vs. 4%) were not significantly different in both groups. Besides, both group A and B had statistically similar APGAR scores at 1<sup>st</sup> (8.66±0.87 and 8.80±0.83 respectively, p=0.414) and 5<sup>th</sup> min (9.66±0.68 and 9.74±0.59 respectively, p=0.537).</p> <p><strong>Conclusions:</strong> Epidural labour analgesia can be safely recommended as a method of labour analgesia, provided the prerequisites are fulfilled. It has no significant adverse effect on the mode of delivery.</p> Marufa Khatun M. Abdur Rahim Fatema Rahman Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 837 841 10.18203/2320-1770.ijrcog20240774 Comparison between colposcopic and biopsy findings to determine the frequency cervical intraepithelial neoplasia I to III in visual inspection with acetic acid <p><strong>Background:</strong> While visual inspection with acetic acid (VIA) is an effective and affordable screening tool, the determination of the severity of cervical intraepithelial neoplasia (CIN) relies heavily on the expertise of healthcare professionals and the interpretation of colposcopic and biopsy findings. The aim of this study is to compare the frequency CIN I-III in VIA positive cases with the help of colposcopic and biopsy findings.</p> <p><strong>Methods:</strong> The prospective cross sectional descriptive study conducted among the VIA positive cases (n=100) who were attending at in colposcopic clinic of department of obstetrics and gynecology, Dhaka Bangabandhu Sheikh Mujib medical university (BSMMU) during 1<sup>st</sup> June 2010 to 30<sup>th</sup> August 2010. History includes present and past illness, personal, family history, drug history and blood pressure were done.</p> <p><strong>Results:</strong> The mean duration of married life was 16.8±10.6 years and more than a half (52.0%) of the patients’ age was 15-20 years of their first intercourse. More than one fourth (27.0%) of the patients had irregular menstrual cycle and 10.0% patients were menopause. Most (72.0%) of the study patients were multipara and the mean age of 'last confinement was 7.8±6.8 years. Majority 38(38.0%) of the patient was normal, 25 (25.0%) of the study patients had CIN I and CIN II in 13 (13.0%), CIN III in 5 (5.0%), 4 (4.0%) had invasive carcinoma and 15 (15.0%) unsatisfactory colposcopy. The colposcopic related biopsy findings was observed, 27.1% of the study patients had CIN I, 12.9% had CIN II, 12.9% invasive carcinoma, 5.9% had CIN III and 5.9% had inflammatory change.</p> <p><strong>Conclusions: </strong>CIN III in colposcopic-related biopsy findings was associated with a mixture of CIN I and CIN III in colposcopic examinations. Invasive carcinoma in biopsy results was linked to a combination of CIN III and invasive carcinoma in colposcopic findings.</p> Khaleda Akter Bhuiyan Deepa Das Mumu Tasnuva Sharmin Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 842 847 10.18203/2320-1770.ijrcog20240775 A cross-sectional study to evaluate uploader-based quality and reliability of content on YouTube about endometriosis <p><strong>Background:</strong> Endometriosis is characterized by the development and presence of endometrial glands and stroma outside of the uterine cavity. Reflux of endometrial tissue fragments, cells, and protein-rich fluid into the pelvis during menstruation is considered the most important mechanism for the development of endometriosis, which is termed reflux menstruation. This study aims to assess quality and reliability of information on YouTube related to endometriosis.</p> <p><strong>Methods:</strong> A cross-sectional observational study of YouTube videos was conducted in April 2023. Videos related to endometriosis were searched by six authors, easy using one search term. Relevant videos in English or Hindi language of duration 1-20 minutes were included in the study. These were evaluated for type of uploader, popularity, type of content and lastly quality and reliability using global quality score (GQS) and DISCERN scores respectively.</p> <p><strong>Results:</strong> The 67 relevant videos conveying Endometriosis related information had 21,620,808 views, 120,830 likes and 11,655 comments. Around 31 (46.3%) of videos uploaded were by doctors and health care organizations, outnumbering those uploaded by news channels 14 (20.9%), patients 5 (7.5%), and others 17 (25.4%). 59 (88.06%) of these videos described symptoms of endometriosis, and 67.1% presented the cause or etiology. A total of 47 (70.1%) of videos discussed information regarding treatment options.</p> <p><strong>Conclusions:</strong> YouTube videos have a wide reach among audience. In this study it was found that there was no significant difference in the quality, reliability or video power index (VPI) of videos uploaded by different types of uploaders. It is important to ensure that content with high quality and reliability is available from qualified medical professionals and organizations; for viewers to understand their disease and take treatment decisions.</p> Shereece Clarke Monica Ghotra Mahima Kuruvila Aarushi Venkatraman Vasishtha A. Upadrasta Khrystyna Melnyk Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 848 852 10.18203/2320-1770.ijrcog20240776 The association of serum ferritin with preeclampsia and its severity <p><strong>Background: </strong>Preeclampsia, a pregnancy-related condition with heightened blood pressure and organ damage after 20 weeks, prompts concern. Serum ferritin, an iron-storing protein, gauged by blood tests, mirrors iron levels. Investigating link before conception between serum ferritin and preeclampsia could impact how we identify, manage, and treat this condition during pregnancy. Study aimed to assess the association of serum ferritin with preeclampsia and its severity.</p> <p><strong>Methods:</strong> This case-control study was conducted in Bangabandhu Sheikh Mujib medical university hospital and Dhaka medical college hospital, Dhaka, Bangladesh from July 2011 to June 2012. A total of 100 pregnant women, comprising 50 cases (Preeclamptic) and 50 controls (Normal pregnant women), were purposively included as study subjects. Data analysis was performed using SPSS version 23.0.</p> <p><strong>Results:</strong> In the case group, 64% were with mild and 36% with severe preeclampsia. Mean serum ferritin was significantly higher in cases than in controls (p&lt;0.001); 76% of cases had elevated serum ferritin, compared to 44% in controls (p=0.001). Severe preeclampsia group had a mean serum ferritin of 192.8, mild preeclampsia group had 86.1, and normal pregnant women had 21.7 ng/ml, indicating higher serum ferritin with preeclampsia severity (p&lt;0.001).</p> <p><strong>Conclusions:</strong> Preeclamptic cases exhibit significantly elevated serum ferritin levels, with a fourfold increased likelihood compared to normal pregnancies. Furthermore, the severity of preeclampsia is associated with higher serum ferritin concentrations in comparison to uncomplicated pregnancies.</p> Nasima Akhter M. Azharur Rahman Ashik Mahmud Saima Rahman Rabab Sultana Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 853 856 10.18203/2320-1770.ijrcog20240777 Periodontal disease and pregnancy outcome in low-risk pregnant women <p><strong>Background: </strong>Preterm delivery is an important cause of neonatal morbidity and mortality. Various infections in the pregnant mother may play a role. Periodontal disease in pregnancy is associated with preterm, low birth weight and small for gestational age neonates. The objective of this study was to correlate the association between periodontal disease and pregnancy outcome in low-risk pregnant women.</p> <p><strong>Methods:</strong> This was a prospective observational study from November 2019 to May 2021 at Ramaiah medical college and hospitals, Bengaluru. All pregnant women with gestational age &lt;32 weeks and without any risk factors receiving antenatal care at Ramaiah hospitals were included.</p> <p><strong>Results: </strong>The study included 109 pregnant women without any risk factors. Periodontitis was found in 50.45%. The Plaque Index mean was 1.237 in cases and 0.844 in controls and was significant. Mean gingival index of cases was 1.282 and of control was 0.913. Nearly 94.5% of cases were having gingivitis and only 24.1% were having gingivitis in controls. The difference was significant. Preterm delivery was seen in 63.6% of cases and in 7.4% of controls which was significant. The birth weight of newborns was &lt;2.5 kg in 69.1% in cases and 9.3% in controls which was significant.</p> <p><strong>Conclusions: </strong>Periodontal disease in pregnancy is an important risk factor for preterm delivery and low birth weight. Periodontal disease can be diagnosed by simple oral examination and can be treated. Early treatment in pregnancy leads to a successful outcome.</p> Prerna Anadure Nandini Gopalakrishna Ashwini Shashank Hiremath Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-05 2024-03-05 13 4 857 861 10.18203/2320-1770.ijrcog20240657 Relation between serum hormones and semen parameters in sub-fertile males: is 17-hydroxyprogesterone really a game changer? <p><strong>Background:</strong> Semen analysis and serum hormone assessment remains an integral part of assessment of infertile males. 17-OHP has recently been demonstrated as a very good marker of intratesticular testosterone environment. Our study was designed to find relationship between individual serum hormone levels and semen parameters in sub fertile men, and to find whether 17-OHP fares better or worse in predicting baseline semen parameters compared to other routinely tested hormones.</p> <p><strong>Methods:</strong> A retrospective analytical study was conducted on 74 patients, after matching inclusion and exclusion criteria, from July 2022 to December 2023. All included patients were investigated with Semen analysis and Serum biomarker levels (FSH, total testosterone, estradiol, total testosterone/estradiol (T/E2) ratio, and 17-hydroxyprogesterone).</p> <p><strong>Results:</strong> Only 10 patients (13.51%) had normal semen analysis, while rest 64 (86.49%) had abnormality in at least 1 semen parameter. Serum testosterone and T/E2 ratio had significant difference (p&lt;0.05) between the two groups. Comparing individual semen parameters against all hormones, FSH and total testosterone had significant association with sperm count, concentration and total motility. Total testosterone also had a significant relation with progressive motility, morphology and semen volume (p&lt;0.05). T/E2 ratio had significant association with Sperm count, motility and morphology, and semen volume (p&lt;0.05). But, 17-OHP and estradiol were not found to have any significant association with any baseline semen parameters in our study (p&gt;0.05). But, serum 17OHP was found to be significantly associated with sexual dysfunction in males (p&lt;0.05).</p> <p><strong>Conclusions:</strong> Our study inferred that serum FSH, testosterone level and T/E2 ratio can be used to predict baseline semen parameters, but 17OHP did not have any association with baseline semen parameters. However, serum 17OHP can serve as a novel marker for male sexual dysfunction.</p> <p> </p> Archi Ghanti K. M. Kundavi Shankar Yamini Asokan Geetha V. Rashmi G. V. Nithya M. Naaram Hemaniveda K. R. Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-19 2024-03-19 13 4 862 867 10.18203/2320-1770.ijrcog20240690 Analysis of maternal and foetal outcome of post-dated pregnancy in a tertiary care centre <p><strong>Background:</strong> Managing pregnancy with post-dates is becoming a challenging issue due to increasing fetal morbidity and mortality. The study aimed to analyse the maternal and fetal outcomes of post-term pregnancies among Indian women, considering their earlier fetal maturation. Conducted over 18 months with 100 cases, the prospective observational study focused on pregnant mothers at or beyond 40 weeks gestational age, excluding those with certain medical complications.</p> <p><strong>Methods:</strong> After obtaining approval from the ethics committee and informed consent from eligible participants, detailed histories and examinations were conducted, with close monitoring until delivery and postnatal care. Inclusive criteria encompassed singleton pregnancies with cephalic presentation, while exclusions included non-cephalic presentation, congenital anomalies, and various medical complications.</p> <p><strong>Results:</strong> Revealed a predominance of primigravida women aged 20 to 35 years at 40 to 40 weeks and 6 days gestation. Spontaneous delivery occurred in 58%, with 90% delivering vaginally, while all multigravida births were vaginal post-induction. Cesarean sections were performed in 14%, primarily due to failed induction followed by fetal distress. Meconium-stained liquor was most prevalent at 42 weeks or later, correlating with higher perinatal mortality and NICU admissions in infants born beyond 42 weeks.</p> <p><strong>Conclusions:</strong> Vigilant monitoring proved crucial in averting fetal jeopardy, emphasizing the importance of timely interventions to mitigate complications associated with post-term pregnancies. This study sheds light on the unique considerations and outcomes of post-dated pregnancies in the Indian population, contributing valuable insights for maternal and neonatal care in similar settings. </p> Ramadevi G. Sailaja C. H. Madhuri C. H. Anuragamayi Y. Sujatha Ryali Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 868 873 10.18203/2320-1770.ijrcog20240778 Maternal mortality in a tertiary hospital of North India- analysis of causes and risk factors <p><strong>Background:</strong> Approximately 529,000 women die from pregnancy-related causes annually and almost 99% of these occur in developing nations. Even with decline, India still is one of the major contributors to maternal deaths in the world. Hence, the present study was conducted to assess the causes, sociodemographic factors and level of delay influencing maternal mortality.</p> <p><strong>Methods:</strong> A retrospective descriptive study based on all maternal deaths within 2.5 years from June 2020 to December 2022 in tertiary care center New Delhi was included. All deaths were assessed for sociodemographic risk factor and processed using descriptive statistics for various variables.</p> <p><strong>Results:</strong> During the study 77 deaths were identified. 48 deaths were direct and 29 were indirect maternal deaths. Sepsis and infectious diseases were the leading cause of direct and indirect maternal death respectively. 47% women died at more than 34 weeks’ gestation.12 women died undelivered. 65 women who died in the postpartum period, caesarean section was performed in 32%. Of total deaths 53 women were unbooked and level 1 delay in 78% cases.</p> <p><strong>Conclusions:</strong> Education and awareness of importance of antenatal care, diagnosis and management of anemia to be given prime importance. Institutional deliveries to be encouraged. Optimization of comorbid conditions in the preoperative period is quintessential.</p> Urvashi Miglani Jasmine K. Kohli Poonam Laul Monika S. Grover Richa Madan Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 874 878 10.18203/2320-1770.ijrcog20240779 Association of metabolic syndrome with gestational hypertension <p><strong>Background:</strong> Metabolic syndrome is a group of clinical, metabolic and biochemical abnormalities with negative impact on global health. The aim of the study was to determine the association between metabolic syndrome and pregnancy induced hypertension, and incidence and effects of metabolic syndrome in pregnant patients.</p> <p><strong>Methods:</strong> Prospective observational study, performed in the Department of Obstetrics and Gynecology, Holy Family Hospital, New Delhi. Antenatal women before 20 weeks of gestation were enrolled in the study. Metabolic syndrome was diagnosed by utilizing the pregnancy adaptation of MeS criteria of NCEPATP III laboratory and clinical criteria. Cases were followed throughout pregnancy to observe their progression into hypertensive disorders of pregnancy i.e. gestational hypertension, pre-eclampsia and eclampsia.</p> <p><strong>Results:</strong> Out of 100 cases with metabolic syndrome 37% developed PIH, 21 developed pre-eclampsia and 14 developed gestational hypertension, 2 patients developed eclampsia as compared to controls in which only 10% developed PIH among which only 3% developed pre-eclampsia.</p> <p><strong>Conclusions:</strong> Our study demonstrates a higher rate of complicated pregnancy with higher incidence of PIH in association with metabolic syndrome compared to control group. Each component of metabolic syndrome increases the probability of PIH. The addition of components of metabolic syndrome exacerbates this probability, especially the combination of increased BMI, increased blood sugar levels and increased triglycerides.</p> Nowsheen Khan Syed Basit Danish Ahmed Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 879 883 10.18203/2320-1770.ijrcog20240780 The impact of grand multiparity on late pregnancy and early labour, hospital-based study on Garhwal region, Uttarakhand <p><strong>Background:</strong> Grand multiparity has been associated with adverse outcome for both fetus and mother such as antepartum hemorrhage, malpresentation, caesarean section rate, postpartum hemorrhage, iron deficiency anemia, and a high perinatal mortality rate. This study aimed to estimate the proportion of the antenatal, intrapartum and perinatal complications outcomes related to grand multiparity.</p> <p><strong>Methods:</strong> This is a prospective observational study conducted during a period of 1 year from 2021 to 2022 in the department of obstetrics and gynaecology, Himalayan hospital, Jollygrant, Dehra Dun, Uttarakhand. 60 grand multiparous patients who delivered during this period was analysed. Mothers with fetus/neonates were assessed for antenatal and obstetrical complications, mode of delivery and post-partum complications.</p> <p><strong>Results:</strong> During the study period, majority of women were in age group 26-30 years (45%), from plain areas (60%), and hilly areas (40%), 85% patients delivered vaginally, while 15 patients delivered by lower segment caesarean section. The main indication of C section was previous 2 LSCS. Maternal complications noted were anemia (30%), preterm labour (23.3%), malpresentation (1.7%) and placenta previa was seen in 3.3% women. Atonic PPH was noted in 10% cases. In present study there was no maternal death reported among grand multipara. 61 babies were born, in which 1.6% neonates were still born. There were no perinatal deaths. 34.45% newborns were born with low birth weight.</p> <p><strong>Conclusions:</strong> Grand-multiparity is an obstetric risk factor. Proper antenatal care, education, properly timed caesarean section in selected cases would reduce the grand-multiparity associated adverse pregnancy outcomes.</p> Samridhi Kumari Nidhi Chauhan Ashnoor Bansal Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 884 889 10.18203/2320-1770.ijrcog20240781 Comparison of chromohysteroscopy findings with histopathological findings in abnormal uterine bleeding <p><strong>Background: </strong>Aim was to compare histological diagnosis of differently stained endometrial tissue on chromohysteroscopy.</p> <p><strong>Methods: </strong>A total of 80 patients diagnosed with AUB and satisfying the study design were included in the study. Hysteroscopy followed by chromohysteroscopy was done using 1% methylene blue. Staining patterns were observed and guided biopsies were taken from differently stained areas and sent for histopathology.</p> <p><strong>Results:</strong> On chromohysteroscopy, out of the 80 participants, 53 (66.3%) had focal staining and 27 (33.7%) had diffuse staining. The overall sensitivity, specificity, PPV and NPV of TVS in diagnosing uterine abnormalities was 51.7%, 45.1%, 34.9%, 62.2% respectively. The overall sensitivity, specificity, PPV and NPV for hysteroscopy were 96.6%, 41.2%, 48.3%, 95.5% respectively. The indices for chromohysteroscopy were as follows: sensitivity-69% for focal and 31% for diffuse staining, specificity-49.0% for focal staining and 69.7% for diffuse staining, PPV-43.5% for focal and 33.3% for diffuse staining, NPV-73.5% for focal staining and 62.3% for diffuse staining.</p> <p><strong>Conclusions: </strong>The idea of staining of endometrium and taking a guided biopsy is exciting and is undoubtedly, better than a blind sampling. However, subjecting all the patient of AUB to chromohysteroscopy in order to find a major histopathological difference is questionable and needs larger trials to reach to concrete decision.</p> Amanpreet Kaur Mini Bedi Parvinder Singh Pulkita Lamba Harbhajan Kaur Vijay Suri Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 890 894 10.18203/2320-1770.ijrcog20240782 Study of fetomaternal implications in intrauterine growth restriction pregnancies <p><strong>Background:</strong> Fetal growth restriction (FGR) is a pathological condition in which a fetus has not achieved its genetic growth potential. FGR incidence is 6 times higher in underdeveloped and developing countries as compared to the developed world.</p> <p><strong>Methods:</strong> This is a retrospective study done in the department of obstetrics and gynaecology, civil hospital and B. J. Medical college, Ahmedabad over the period of 6 months from December 2022 to May 2023. A total of 30 cases of intrauterine growth restriction (IUGR) pregnancies were studied.</p> <p><strong>Results:</strong> Majority of the study population, 60% belonged to younger age group of 20-30 years. Multiparity was associated with IUGR babies. Majority of patients i.e. 76.66%. Presented at gestational age of ≥37 weeks and 23.33% at &lt;37 weeks. Most IUGR babies (73.33%) had a birth weight between 2 to 2.5 kg. One third of babies required NICU admission while the perinatal mortality was 10%. Doppler changes in umbilical artery were noted in 27% of cases of IUGR. Among risk factors anemia, preeclampsia and oligohydramnios had equal contributions at 10% each. Previous history for SGA baby is a significant association in 16% of cases. Induction of labor was done in 60% cases, 63% were delivered vaginally and rest via lower segment caesarean section (LSCS), the most common indication of LSCS was fetal distress.</p> <p><strong>Conclusions:</strong> The study concluded that IUGR continues to be one of the major etiological factors for fetal morbidity and mortality and increase in rates of LSCS contributing maternal morbidity. IUGR was commonly observed in multigravida patients lacking antenatal care. Anemia and hypertensive disorders of pregnancy as well as oligohydramnios are the potential risk factors for IUGR.</p> Prachi Sharma Amiya U. Mehta Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 895 898 10.18203/2320-1770.ijrcog20240783 Maternal near miss: a retrospective study in a tertiary care hospital at South India <p><strong>Background:</strong> A maternal near miss (MNM) case is defined as a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy. MNM situations tend to mirror the causes of maternal death. Hence, review of these cases has been found to help in the assessment of maternal health services. These cases are called as MNM or severe acute maternal morbidity (SAMM) and auditing these cases is called near miss audit (NMA).</p> <p><strong>Methods: </strong>A retrospective study of 201 MNM cases over a period of 12 months from January 2023- December 2023. Demographic data were collected from MNM review form and records. Data studied and analyzed.</p> <p><strong>Results:</strong> There were 11,340 deliveries and 11,126 live births during the study period out of which 201 MNM cases were studied. Haemorrhage followed by anemia was the most common cause of near miss events. The most common age group affected in the near miss cases in the present study was 20 to 35 years (80%). Majority of the cases were referred from the nearby PHCs and government hospitals.</p> <p><strong>Conclusions:</strong> Most maternal deaths are preventable by optimal utilization of existing MCH facilities, identifying the bottleneck in health delivery system, early identification of high-risk pregnancy and therein timely referral to tertiary care centre.</p> Subha Sivagami Sengodan Tejashwini Mallesh Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 899 903 10.18203/2320-1770.ijrcog20240784 Clinico-histopathological study of gonadal and extragonadal teratomas in tertiary care centre <p><strong>Background:</strong> Teratomas are quite often seen in the gonadal region. As compared to gonadal teratoma extragonadal teratomas are very rare. They can be mature, immature, malignant or mixed germ cell tumor. Many a times they are missed clinically because of their rare locations that include retroperitoneum, sacrococcygeal, mediastinum, thyroid, eye, ear, and mesentery. In such locations the list of clinical differentials is long and it is difficult for the clinicians to make an accurate clinical diagnosis. Aims of the study were: to identify the different locations of extragonadal teratoma, to know the histological types of teratoma in different location, and to correlate histopathological diagnosis and clinico-radiological diagnosis.</p> <p><strong>Methods:</strong> It is an observational descriptive study of histopathologically proven teratomas over a span of 2 years from July 2021 to July 2023.</p> <p><strong>Results:</strong> Out of total 35 cases of teratomas, we had received 14 cases of extragonadal teratomas. The most common sites being sacrococcygeal region. They were most common in the paediatrics age group and most common sex involvement was of male.</p> <p><strong>Conclusions:</strong> While interpreting the histopathological findings, a high index of suspicion for teratomas needs to be kept even if the site is not a gonadal location. Simple excision is a cure for this condition or else it may transform to malignancy.</p> Fatema Topiwala Jyoti Gorade Marium Siddiqui Dharitri Bhat Archana Deshpande Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 904 910 10.18203/2320-1770.ijrcog20240785 Association of abruptio placenta in patient with pre-eclampsia with severe features and without severe features <p><strong>Background:</strong> Placental abruption is responsible for increased risk of maternal and fetal morbidity and mortality worldwide. Studies specific to placental abruption in pregnancy-induced hypertension (PIH) are still lacking. This study is designed to focus on collecting data on placental abruption and to objectively determine its impact on the outcome of pregnancy complicated with PIH in terms of improving fetal and maternal morbidity and mortality.</p> <p><strong>Methods:</strong> This was retrospective observational study conducted at Cheluvamba Hospital, Mysore Medical College and Research Institute (MMCRI), Mysore, in the department of obstetrics and gynaecology. All pregnant women with diagnosis of abruptio placenta over 28 weeks and with PIH between January 2022 to August 2023 were included. Data was collected from medical records department and results were analysed.</p> <p><strong>Results:</strong> During the study period there were total of 14027 deliveries. Of this 63 (0.44%) occurred in patients with placental abruption with PIH. Mean age group was 24.57 years; majority were multigravida (58.46%) Majority were preterm (77.77%). 61.90% had pre-eclampsia with severe features. Mean systolic blood pressure (SBP) was 151.90 mmHg, diastolic blood pressure (DBP) was 98.73 mmHg. 65.08% delivered by caesarean section. 47.61% was the perinatal mortality, perinatal asphyxia was 45.71%, prematurity was 65.71%, low birth weight was 84.12%. 71.42% was the neonatal intensive care unit (NICU) admission rate. Maternal complications seen was postpartum haemorrhage (PPH) (31.74%), requiring blood and blood products transfusion (63.49%), coagulopathy (14.28%), shock (12.69%). 4 women developed severe features of pre-eclampsia in postpartum period, 2 of them needed MgSO<sub>4</sub>. 58.73% had requirement of antihypertensives in postpartum period.</p> <p><strong>Conclusions:</strong> Abruption is one of the obstetric emergencies. In our study severe adverse maternal and perinatal outcomes were more pronounced in pre-eclampsia with severe features and it needs an individual and intense surveillance and management to have better maternal and perinatal outcome.</p> Rakshith Nagaraj Hemalatha C. Ramakrishnappa Anusha B. Chandrashekhar Swathi L. Iyengar Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 911 915 10.18203/2320-1770.ijrcog20240786 Analysis of socio-economic factors influencing caesarean section rates in Maharashtra, India <p><strong>Background:</strong> The aim of the present study is to investigate the socio-demographic and economic determinants of caesarean (C-) section deliveries in Maharashtra. The paper also focuses to estimate inequalities in C-section deliveries in the state.</p> <p><strong>Methods:</strong> The fifth round of the National Family Health Survey (NFHS) 2019-21 was used to accomplish the objective. Univariate, bivariate and logistic regression were used to ascertain the determinants of C-section.</p> <p><strong>Results:</strong> The prevalence of C-section delivery in India rose from 2.9% during 1992-93 to 10.6% in 2005-06 and to 21.5% during 2019-21. The proportion of C-section delivery in Maharashtra during 2019-21 is observed to be 25.4%, with 18.3% of the deliveries occurring at public health facility, while 38.9% of the deliveries takes place in private health care settings. Women residing in urban areas, belonging to richer wealth asset index and having higher educational qualification are found to have greater chance of caesarean deliveries.</p> <p><strong>Conclusions:</strong> The study reveals that C-sections have increased dramatically in Maharashtra over the previous three decades. The hospital administration is encouraged to take effective actions to reduce the likelihood of needless C-sections while retaining medical justification for C-section births.</p> Rushikesh Premdas Khadse Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 916 921 10.18203/2320-1770.ijrcog20240787 Pregnancy outcome in women with bacterial vaginosis <p><strong>Background:</strong> Bacterial vaginosis is a condition characterized by alteration in the vaginal flora. It is a common occurrence during pregnancy and is one of the established risk factors for preterm delivery, premature rupture of membranes and chorioamnionitis. The objective of the study was to study the prevalence and effects of bacterial vaginosis during pregnancy.</p> <p><strong>Methods: : </strong>The study was a hospital based prospective study conducted in the department of obstetrics and gynaecology, RIMS, Imphal from January to December, 2021. 250 women between 20-28 weeks of gestation underwent examination and testing for bacterial vaginosis and were followed up till delivery. Pregnancy outcomes like pre-term labour, premature rupture of membrane; fetal outcomes like birth-weight, APGAR score, NICU admission, or any other complications were noted.</p> <p><strong>Results:</strong> Out of the 250 singleton pregnancies, 48 women (19.2%) were found to have bacterial vaginosis. Pregnancies associated with bacterial vaginosis had more chances of premature rupture of membranes, low birth weight babies. But, there was no significant association of the same to preterm labor and to the rate of NICU admission of the newborns.</p> <p><strong>Conclusions:</strong> Vaginal infection during pregnancy should also be entertained seriously and treated well since bacterial vaginosis may directly or indirectly be related to preterm delivery and low birth weight babies.</p> Snehangshu Das Namoijam Basanti Ajitkumar Singh Neiketouzo Kulnu Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 922 925 10.18203/2320-1770.ijrcog20240788 Evaluation of efficacy of CO2 fractional laser in genitourinary syndrome in menopausal women: a prospective observational study <p><strong>Background: </strong>Objective were to evaluate the efficacy of fractional CO<sub>2</sub> laser in treating genito-urinary syndrome (GSM).</p> <p><strong>Methods:</strong> We did a prospective observational study on 92 post-menopausal women aged 37-84 years during December 2022-December 2023 in a private clinic of district Kanpur. Fractional CO<sub>2</sub> laser (Rosch, vaginal 360<sup>0</sup> probe) in three sittings were done for women presenting with GSM at the interval of four weeks as a lunch break therapy. The outcome was studied in terms of visual analogue scale (VAS) having 0 to 10 rating at second, third and sixth months. The statistical analysis was performed using MS excel and GraphPad online statistical calculator.</p> <p><strong>Results:</strong> Stress urinary incontinence, early prolapse, urinary incontinence was the commonest presenting complaints among females. Significant improvement was observed in VAS score in each follow up.</p> <p><strong>Conclusions: </strong>The vaginal fractional CO<sub>2</sub> laser can be used as an effective and safe treatment method in GSM. It is necessary to conduct studies with long-term follow-up.</p> Sangeeta Arya Nidhi Johri M. Maroof Pragya Trivedi Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 926 929 10.18203/2320-1770.ijrcog20240789 A comparative study of intrapartum epidural analgesia with intramuscular tramadol on labor outcome <p><strong>Background:</strong> Epidural analgesia produces analgesia in labour without affecting nervous system, allows the mother to be well oriented, fully conscious and alert throughout labour. The aim of this study is to study the effect of epidural analgesia and intramuscular (IM) tramadol in different stages of labour and compare the effect of epidural analgesia with intramuscular tramadol on progress of labour and its outcome.</p> <p><strong>Methods:</strong> Continuous monitoring of the haemodynamic parameters of the mother was done using multiparameter monitors. Foetal monitoring was done using continuous cardiotocography (CTG) monitor. Primigravida in spontaneous labour were randomly divided into two groups. Group I received epidural analgesia and group II received IM tramadol.</p> <p><strong>Results:</strong> Duration of Ist stage of labour in group I was 167.0±47.2 min and in group II was 214.4±50.2 min. Mean duration of III stage of labour in the present group I was 7.9 min and 7.5 min in the group II. In the present study, total duration of labour is shortened by 47 min in group I compared to group II.</p> <p><strong>Conclusions:</strong> Epidural analgesia during labour is a simple and effective method for painless and safe delivery. Analgesia produced by epidural route is significantly more effective than intramuscular tramadol. Epidural analgesia has favourable effect on the progress of labour. In developing nations where availability of facilities is the main limiting factor, intramuscular tramadol which is a safe and satisfactory drug for relief of labour pain, can be considered as a suitable alternative.</p> Syed Basit Nowsheen Khan Annum Bano Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 930 934 10.18203/2320-1770.ijrcog20240790 A comparative study of episiotomy suturing using suture material chromic catgut versus Rapide Vicryl and its outcome <p><strong>Background:</strong> Episiotomy is a surgical incision which is made in the perineum to enlarge the vaginal opening for birth, with a purpose to facilitate the completion of the second stage of labour to improve both the maternal and the neonatal outcomes. A significant number of women experience perineal trauma following vaginal deliveries which may result in perineal pain, dyspareunia and faulty healing. The type of suture material which is used, will influence these factors. Objectives were to assess the effect of suture materials (Rapide Vicryl versus catgut) used in episiotomy and evaluate the wound healing characteristics on day 2 and day 7.</p> <p><strong>Methods: </strong>All the pregnant women in labour admitted in labour room of Navodaya medical college, 200 patients satisfying the inclusion and exclusion criteria were taken and were assigned in one of the groups for episiotomy and suturing was done using either of the materials-Vicryl Rapide 2-0 or chromic catgut 1-0, followed up the women in the postnatal ward on day 2 and day 7 and look for immediate complications of episiotomy like temperature, severe pain, hematoma induration, wound gapping and discharge.</p> <p><strong>Results: </strong>Among a total of 200 cases, at 48 hours, there was no significant difference according to the pain measurement scores, but the median consumption of analgesics was significantly lower with fast-absorbing polyglactin 910. There was no difference in the association with dysparenia at 6 weeks after the delivery between chromic catgut (19%) compared with standard polyglactin 910 group (8%).</p> <p><strong>Conclusions:</strong> Fast-absorbing form of polyglactin sutures are preferred over chromic catgut because of their non- allergic properties, increased tensile strength, lesser probability of pain and lower chances of infection.</p> Trupti Ruge Lathasri A. Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 935 941 10.18203/2320-1770.ijrcog20240791 Efficacy of early versus late postpartum DIPSI test in gestational diabetes mellitus women for follow up <p><strong>Background:</strong> The present study aimed to evaluate if postpartum gestational diabetes mellitus (GDM) screening can be performed during immediate post-delivery 72 hrs instead of six weeks postpartum for follow-up.</p> <p><strong>Methods:</strong> Total 150 GDM patients were included. The sample size was calculated as 150 with Nimaster2.0 software. GDM patients are enrolled after meeting the exclusion criteria for the study. The GDM diagnosis was made by DIPSI test and treated as per guidelines. After delivery, the Dipsi test was done on PND-3 (PP1). Furthermore, all were kept on LSM irrespective of the glycaemic level DIPSI test was repeated in all Patients after 45 days (PP2).</p> <p><strong>Results:</strong> All 150 patients had a DIPSI test on 3<sup>rd</sup> day post-partum (PP1) and repeat test at 45 days (PP2)., Of these, 60 patients (40%) showed negative DIPSI test on P1 and all remained in Group 1, with 63 patients having negative DIPSI test on PP2. 50 patients (33.3%) had blood glucose between 140-199 mg (Group 2) on PP1 and increased to 53 patients in PP2 in 45 days. 40 patients had diabetic (26.6%) value (Group 3) in PP1, and out of them 34 (22.6%) remained in group 3 in PP2 after 45 days post-partum.</p> <p><strong>Conclusions:</strong> This pilot study shows that nearly 60% of the GDM patient have either IGT or diabetic value following delivery on 3<sup>rd</sup> day of PP1 and almost similar results in PP2. Hence, we can do the postpartum screening on the postpartum 3<sup>rd</sup> day and need not wait for 6 wks when more than 50% is lost for follow-up. This study shows among GDM 60% of them have underlying beta cell dysfunction.</p> Geethalakshmi A. Saraswathi S. Kalaivani K. Anjalakshi C. Rajesh Jain Seshiah V. Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 942 947 10.18203/2320-1770.ijrcog20240792 Effect of maternal body mass index on pregnancy outcome: a retrospective observational study at a secondary level care hospital in India <p><strong>Background:</strong> Maternal BMI outside the range of 18.5 to 24.9 is associated with adverse maternal and/or foetal outcome. In India, due to extreme socioeconomic distribution, double burden of malnourishment &amp; obesity is being observed, though it varies from state to state. Many studies are conducted showing association of obesity with pregnancy outcome, while importance of underweight is not studied frequently in our geographical area, hence this study was planned to be conducted.</p> <p><strong>Methods: </strong>Our aim was to evaluate the maternal and perinatal outcomes in patients belonging to different BMI categories. We performed retrospective observational study at department of obstetrics and gynaecology, Suri Sadar Hospital, a secondary level care hospital at Birbhum, West Bengal, India between July 2021 to May 2022. Sample size taken was 170. Detailed data were collected from the MCP card (maternal child protection card) of the mothers, antenatal follow up sheets of these women and hospital medical records. The study participants were then divided into 5 groups according to their first trimester BMIs. Statistical analysis was carried out with the help of Micro soft Excel and Epiinfo 7.1 software, p&lt;0.05 were considered significant.</p> <p><strong>Results:</strong> Average mean weight gain in our study was 9.1118 kg and we found significant association between weight gain during pregnancy &amp; BMI status (p&lt;0.001). We also observed significant association of gestational diabetes mellitus, preeclampsia, caesarean section, pre-term labour, post-partum haemorrhage, post-partum wound infection with obese &amp; overweight mother. FGR and MAS were also found to be significantly associated with maternal BMI. Complex maternal metabolic environment on developing foetus in obese mother alone or complicated by PIH or GDM may be the cause. In underweight mother, malnutrition and micronutrient deficiency may lead to development of FGR.</p> <p><strong>Conclusions:</strong> Pre conceptional normal BMI is essential for every woman willing to conceive. Nutrition-sensitive programs like food security, poverty alleviation, women education, women empowerment, dietary consultation for all newly married couples is required for developing countries to prevent altered pre pregnancy BMI.</p> Adrija Ghosal Rashmi Selim Akhtar Bibekananda Das Tushar Kanti Bhattacharya Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 948 952 10.18203/2320-1770.ijrcog20240793 Study to analyse the intraoperative and post-operative complications of total abdominal hysterectomy and total laparoscopic hysterectomy <p><strong>Background:</strong> Laparoscopic hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim of the study was to compare the risks and complications of total laparoscopy hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications.</p> <p><strong>Methods:</strong> A retrospective observational study was conducted in the Gynaecology department at Department of Obstetrics and Gynecology, Central Railway Hospital, Jabalpur, Madhya Pradesh, India. The data for the past 2-year record was taken for analysis. A total of 72 subjects were included in the study and were divided into two groups with 36 patients under TAH (total abdominal hysterectomy) group and 36 under TLH (Total Laproscopic hysterectomy) group. The primary outcome of the present analysis were incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy, postoperative pain, and length of post operative stay.</p> <p><strong>Results:</strong> The mean intra-operative blood loss was measured among both the groups and it was found to be very high among TAH group (215 ml) compared to TLH group (124 ml) and the difference was found to be statistically significant (p&lt;0.05). Similarly, the duration of operative procedure was found to be less in TLH group (46.5 mins) compared to TAH group (76.8 mins) and the difference was found to be statistically significant (p&lt;0.05). Post-operative wound infection (14 vs 0) was found to be more among the patients in TAH group than that of the TLH group and the difference was found to be statistically significant (p&lt;0.05).</p> <p><strong>Conclusions:</strong> TLH is a safe and effective surgical treatment for benign gynaecological diseases and should be offered whenever possible, taking into account the low rate of complications and cost-effectiveness.</p> Gunjan Yadav Meenal Verma Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 953 957 10.18203/2320-1770.ijrcog20240794 A case control study to elicit fetal outcome in high-risk pregnancies and to study the various maternal parameters associated with fetal outcomes <p><strong>Background:</strong> High risk pregnancies (HRP) threaten the health or life of the mother or her fetus. Perinatal mortality varies widely in some developed countries and more than 10 times higher in developing countries. For most women, early and regular prenatal care promotes a healthy pregnancy and delivery without complication.</p> <p><strong>Methods:</strong> It is a prospective study conducted in BMC, Sagar of duration one year, keeping in mind the inclusion and exclusion criteria with 216 (108 control and 108 cases) patients included in our study.</p> <p><strong>Results:</strong> study shows that there is a significantly high incidence of IUGR delivery and preterm delivery in HRP as compared to control.</p> <p><strong>Conclusions:</strong> In our study we conclude that there is a high correlation between HRP and poor perinatal outcome thus identifying HRP is important because it is the first step towards prevention perinatal mortality and morbidity.</p> Jyoti Parmar Sheela Jain Punya Pratap Singh Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 958 962 10.18203/2320-1770.ijrcog20240795 Role of proinflammatory cytokines TNF-α (rs1800629) and IL-6 (rs1800795) in the pathogenesis of polycystic ovarian syndrome in North Indian females <p><strong>Background:</strong> This study aimed to determine whether TNF-α and IL-6 gene polymorphism, their epistatic effects and haplotypes confer pathogenesis of PCOS in north Indian females.</p> <p><strong>Methods:</strong> A case-control study comprising DNA samples of 401 females (200 PCOS cases and 201 controls) of reproductive age. All the subjects were genotyped for TNF-α (-308 G/A) and IL-6 (-174 G/C) genes by tetra-primer ARMS PCR.</p> <p><strong>Results:</strong> There were 41.5% PCOS females revealing hirsutism, 45.5% acne and 36% alopecia. High BMI (p=0.008) and W/H ratio (p=0.0001) was observed among PCOS cases. Frequency of minor allele A for -308 G/A TNF-α was significantly higher in PCOS cases than controls indicating 1.4 fold increased risk for PCOS (p=0.05, OR=1.41, 95% CI=1.00-1.99). -174 G/C IL-6 gene was in association with the decreased risk of PCOS. The epistatic effects of all the possible combinations of both the SNPs shows statistically significant differences (Interaction p value=0.014) indicating modulating effects of TNF-α and IL-6 polymorphism in response to PCOS. Haplotype HT3 AG (p=0.003, OR=2.22, 95% CI=1.31-3.78) was associated with increased risk of PCOS.</p> <p><strong>Conclusions:</strong> The present findings suggest that TNF-α and IL-6 might contribute to pathogenesis of PCOS in north Indian females irrespective of a polymorphism of TNF-α (-308 G/A) and IL-6 (-174 G/C) genes.</p> Parneet Kaur Khushpreet Kaur Rajinder Kaur Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 963 970 10.18203/2320-1770.ijrcog20240796 Effectiveness of compression of myometrium and occlusion of uterine artery by COMOC-MG suture in management of atonic postpartum hemorrhage <p><strong>Background: </strong>Postpartum haemorrhage (PPH) remains a significant cause of maternal morbidity and mortality globally, with uterine atony being a primary etiological factor. This prospective interventional study aimed to assess the effectiveness of the compression of myometrium and occlusion of uterine artery by COMOC-MG suture technique in managing atonic PPH.</p> <p><strong>Methods: </strong>A prospective study was conducted at GK general hospital, Bhuj, Gujarat, from December 2020 to July 2022. The study enrolled 100 pregnant women without identified risk factors undergoing complicated caesarean or vaginal deliveries. The COMOC-MG suture technique was employed for the study group, while the control group received standard atonic PPH management. Outcomes included success rates, blood transfusion needs, complications, and mortality.</p> <p><strong>Results: </strong>The study group (n=50) demonstrated comparable demographic characteristics to the control group. Notably, the COMOC-MG group exhibited higher success rates in normal (100%) and cesarean deliveries (95.3%) compared to the control group (72.7% and 60.7%, respectively). Lower blood transfusion needs (34% vs. 48%) and fewer complications were observed in the COMOC-MG group. Hemoglobin (Hb) levels on post-partum day 1 showed no significant difference.</p> <p><strong>Conclusions: </strong>The study suggests that COMOC-MG suture technique is effective in managing atonic PPH, showing superior success rates and potentially reducing blood transfusion needs. While further research, including larger trials, is warranted, these findings underscore promise of COMOC-MG as an innovative intervention in obstetric care, offering potential benefits in maternal outcomes. The observed safety profile supports its consideration in clinical practice.</p> Trupangi J. Chaudhari Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 971 977 10.18203/2320-1770.ijrcog20240797 Knowledge, awareness, practice patterns and attitude towards family planning methods in a tertiary centre of North India <p><strong>Background:</strong> Family planning is adopted voluntarily according to the knowledge, awareness and attitude of the individuals and couples. This study aims to assess the level of awareness, knowledge, practice patterns and attitude about family planning methods in a particular area.</p> <p><strong>Methods:</strong> A cross sectional descriptive study was done for 1000 married women and data was obtained by means of a questionnaire.</p> <p><strong>Results:</strong> Most common encountered age group was 21-34 years (69%) in our study. Most of the women were residing in rural areas (81%) as compared to 19% in urban areas. In our study, total of 630 women (63%) were aware of family planning methods. Most of them were aware of condoms (56%), OCPs (50%), IUD (43%) and sterilization (43%). They had least information about natural methods (37%) and injectables (12%). Source of knowledge was TV and internet in 30%, friends, family and husband in 40 % and health centre and health professionals in 30% females. Majority were using condom (68%). Others were using OCPs (16%), IUD (5%) and sterilisation (2%). After counselling 55% of women agreed to use contraception and 31% were not sure whether they would use or not.</p> <p><strong>Conclusions:</strong> Awareness and usage of contraceptives was low in the present study. So, there is need to educate and motivate the couples for using family planning methods.</p> Gagan Lata Liza Gupta Moneet Walia Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 978 982 10.18203/2320-1770.ijrcog20240798 Comparative study of diclofenac, paracetamol infusion, or a combination in post-caesarean patients for pain management <p><strong>Background:</strong> The World Health Organization (WHO) has released fresh information showing that the number of caesarean sections performed worldwide has increased and now accounts for more than one in five (21%) deliveries. 89.8% of women experienced significant post-operative discomfort following a caesarean section and 84.2% reported to have moderate to severe pain. This study aimed to compare diclofenac, paracetamol infusion, and a combination of both in patients of post-caesarean for pain management.</p> <p><strong>Methods:</strong> The study was a cross-sectional study carried out in the department of obstetrics and gynaecology at a tertiary care hospital in a rural area of Panipat, Haryana. A total number of 102 women who underwent caesarean section were taken for the study. They were divided into 3 groups each having 34 women. The first group was given diclofenac, the second was given paracetamol infusion and the third was given a combination of both for pain management.</p> <p><strong>Results:</strong> In our study we have done visual analog score (VAS) scoring at 0, 1, 6, 12, 18 and 24 hours and we found that the mean VAS score in group 3 was highest when compared to other two groups. We also found that on comparing data of VAS score between the three groups the p value came out to significant that is p≤0.001.</p> <p><strong>Conclusions:</strong> We found that combination therapy had good results in comparison to individual therapy and had fewer side effects.</p> Abhilasha Choudhary Swati Pahula Verma Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 983 988 10.18203/2320-1770.ijrcog20240799 Foeto-maternal outcome in pregnancy with and without heart disease: a comparative cross-sectional study in a tertiary care hospital <p><strong>Background:</strong> Pregnant women with underlying heart disease are at increased risk for adverse maternal, obstetric, and neonatal outcomes. One can successfully treat the majority of these incidents if detected early by accurate individual risk assessment and careful follow-up. The aim and objectives of this study were to compare the foeto-maternal outcome in pregnancy with and without heart diseases with period of gestation &gt;32 weeks.</p> <p><strong>Methods:</strong> This study was carried out in a tertiary care teaching hospital of Imphal, the capital city of Manipur, using a standard-questionnaires among patients admitted. Data was analysed using SPSS 21.0 with statistical significance set at p&lt;0.05.</p> <p><strong>Results:</strong> Study was conducted on 112 pregnant women. The prevalence of heart disease was higher (71.4%) among the primiparous women. Highest occurrence of heart disease (66.1%) was seen in the housewife group. There was increased incidence of pre-term deliveries among pregnant women with heart disease (26.8%). Caesarean section (62.5%) and maternal complications (42.9%) were found to be higher among the pregnant women with heart disease. The incidence of NICU admission of babies was higher among mothers with heart disease (17.9%) compare to 5.4% in mothers without heart disease.</p> <p><strong>Conclusions:</strong> Early detection by accurate individual risk assessment and careful follow-up are key to improving outcomes.</p> Miti Ratan Ngashepam Shuradhaja Singh Chirom Pritamkumar Singh Sonam Dolma Nikita Gautam Anmol A. Vaishnav Saurabh Soni Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 989 992 10.18203/2320-1770.ijrcog20240800 Maternal and fetal outcome in second stage caesarean section: a retrospective study <p><strong>Background: </strong>This study aims to observe the maternal and neonatal outcomes of caesarean delivery performed in the second stage of labor.</p> <p><strong>Methods:</strong> This was retrospective observational study conducted at Cheluvamba hospital, Mysore medical college, Mysore, in the department of Obstetrics and Gynaecology. All second stage caesarean sections performed between January 2023 to June 2023 were analyzed in terms of incidence, indications of caesarean-section, intra-operative and postoperative complications, maternal and fetal outcome.</p> <p><strong>Results:</strong> During the study period there were total 4194 deliveries. Out of this 1771 deliveries were done by caesarean section. Out of them 48 were 2nd stage caesarean sections contributing to 2.71% of total sections. Patwardhan method was used in 41.6% cases for delivery of deeply engaged head. Intra-operative complications were higher in terms of atonic pph (25%), hematuria (16.66 %). 14% cases had postoperative fever and 41.6% cases need prolonged catheterization. 20.83% babies required NICU admissions and neonatal death was 4.16%.</p> <p><strong>Conclusions:</strong> Caesarean section in the 2nd stage of labour is associated with increased maternal and neonatal morbidity. A proper judgement is required by a skilled obstetrician to take a decision for caesarean section at full cervical dilatation.</p> Anusha B. Chandrashekhar Hemalata C. Ramakrishnappa Rakshith Nagaraj Swati L. Iyengar Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 993 996 10.18203/2320-1770.ijrcog20240801 Prevalence of postpartum depression and associated risk factors in tertiary health care centre <p><strong>Background:</strong> Postpartum depression (PPD) is defined as a depressive episode occurring during pregnancy or until 4-weeks post-childbirth. It is essential to diagnose postpartum depression since it can disrupt normal maternal and infant bonding and have a negative impact on both the short and long-term development of children. To determine the prevalence of postpartum depression and the associated risk factors in women delivering in a tertiary health care centre.</p> <p><strong>Methods:</strong> A prospective observational study was conducted in a tertiary health care centre from January 2021 to June 2022 for a period of 18 months. Pregnant women were assessed using the Edinburgh postnatal depression scale (EPDS) at 2-3 days postpartum and at 6 weeks postpartum. The cut-off score for detecting major depression is a score greater than or equal to 13.</p> <p><strong>Results:</strong> The study included 204 women, of which postpartum depression was present in 28 women. The prevalence of postpartum depression in this study group is 13.7%. Unplanned pregnancy, neonatal intensive care unit (NICU) admission of newborns, preterm delivery, lack of support from family, complications during pregnancy or birth, and delayed breastfeeding were significantly associated with postpartum depression.</p> <p><strong>Conclusions:</strong> Psychological and emotional well-being should also be given priority in addition to the physical well-being of women. All women who are at high risk should be screened so that PPD can be detected earlier, and support should be extended in the form of counselling and treatment.</p> M. Sri Kiruba Nandini Shanta Bhaskaran Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 997 1001 10.18203/2320-1770.ijrcog20240802 Incidence of decision to delivery interval delay in emergency LSCS and its impact on fetal and maternal outcome: a prospective observational study <p><strong>Background: </strong>Caesarean delivery is a complex multidisciplinary procedure. Decision to delivery interval is supposed to play a significant role in maternal and neonatal outcomes. The present study was undertaken to determine the incidence of DDI delay among pregnant women undergoing Emergency LSCS in tertiary care centres.</p> <p><strong>Methods:</strong> This study was conducted on 400 subjects who underwent emergency LSCS in category I and category II during a period from November 2020 to August 2021.</p> <p><strong>Results: </strong>The maximum patients were from the age group of 25-29 years (43%), primigravida (59.1%), gestational age between 37-40 weeks (78%). 29% have undergone category-1 LCSC and 71.2% have undergone category-2 LSCS. Out of 116 patients underwent category-1 LSCS, 11 (9.5%) patient delay was present whereas in category-2 LSCS out of 284,12 (4.2%) patient delay was present. Among Category-I LSCS the most common indication was Fetal distress and among Category-II LSCS the major indication was non reassuring CTG. Maximum babies have APGAR scores between 7-10 at 1 (N=369) and 5 min (N=398). The mean cord PH was 7.31, ranged from 6.9-7.47. 98 babies required NICU admission and most of them admitted for respiratory distress. 11 patients required blood transfusion. There was no significant association found between various parameters and DDI delay, (p&gt;0.05).</p> <p><strong>Conclusions: </strong>In the present study, the interval between the decision to delivery interval has no significant impact on feto-maternal outcome in Category-I LSCS. Among Category-II LSCS there was a delay in 12 cases, among them 7 babies required NICU admission, the complications among neonates were significantly more when DDI was &gt;75 minutes.</p> Priya T. Singh Karishma Salana Meetali Nehate Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1002 1007 10.18203/2320-1770.ijrcog20240803 Risk of malignancy index 4 for differentiating benign from malignant ovarian tumor <p><strong>Background:</strong> Approximately 22% of gynaecologic cancers are of ovarian origin, but 47% of all gynaecologic cancer deaths occur in women who have ovarian cancer. Ovarian cancer is usually diagnosed at an advanced stage because most of the symptoms are nonspecific, hence, the difficulty in diagnosis at early stages. In general, there is no effective screening test for ovarian cancer. Aim was to evaluate the ability of risk of malignancy index 4 (ROMI 4) to differentiate benign from malignant ovarian tumors.</p> <p><strong>Methods:</strong> A prospective observational study was conducted in April 2019 to march 2020.</p> <p><strong>Results:</strong> In the present study the ROMI 4 score at cut-off ≥ 450 had sensitivity, specificity, PPV and NPV of 74.3%, 65.3%, 42.6% and 88% respectively for malignant ovarian tumor.</p> <p><strong>Conclusions:</strong> Preoperative ROMI 4 score ≥450 will lead to rational basis for further referral to higher centre or gynaecology oncologist timely for appropriate surgical intervention/ management.</p> Chandni Nirbhay Kumar Bind Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1008 1012 10.18203/2320-1770.ijrcog20240804 Laparoscopic shaving for colorectal endometriosis: a literature review <p>Colorectal endometriosis is one of the most challenging conditions to manage. Surgical treatment is required when lesions are symptomatic, impairing bowel, urinary, sexual, and reproductive functions. Preoperative radiological examination should be extensive to determine the appropriate surgery: laparoscopic shaving, disc excision or rectal resection. We demonstrated that in the hands of experienced surgeons, shaving technique is possible in more than 95% of colorectal endometriotic nodules, with low complication rates compared to resection. Shaving and bowel resection are associated with comparable recurrence rates. As shaving is indicated whatever the size of deep lesions, surgeons should first consider rectal shaving to remove deep bowel endometriosis. Bowel resection should only be performed in case of major rectal stenosis (&gt;80%), multiple or posterior lesions and stenotic colorectal nodules.</p> <p> </p> Mounir Moukit Mohammed Rahmoune Ismail Allilou Moulay Abdellah Babahabib Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1082 1085 10.18203/2320-1770.ijrcog20240821 Pre-conception and pre-natal diagnostic techniques act-draconian or a considerate de jure tamer <p>Principles of gender equity are an integral part of constitution. The constitution confers equal rights and opportunities on women; bars discrimination on the basis of sex and denounces practices derogatory to the dignity of women. In spite of this, discrimination against women and girls is almost universal. Forced abortions of female foetuses and prenatal sex determination results in millions of girls not being allowed to be born just because they are girls. Pre-conception and pre-natal diagnostic techniques (PC and PNDT) act were enacted in 1994, amended and effectively implemented in 2003 and strictly amended in 2011, to curb this heinous crime of female foeticide that was taking place due to prenatal diagnostic techniques for determination of the sex of the foetus and thus, to balance the disturbed sex ratio of the country. To achieve the said purposes, the act imposes penalties for the offences committed under this Act, including clerical errors. However, according to the radiologists, the PC and PNDT act has become draconian for all practicing sonologists and radiologists instead of serving the purpose of saving the girl child. This article, explaining the provisions of PC and PNDT act, addresses the concerns of sonologists and radiologists in the light of the judgements passed by Hon’ble Supreme Court of India. It further discusses the hindrances occurring in the usage of evolved medical technology due to the provisions of the Act thereby paving way towards a much-needed legitimate decision to settle the ongoing country-wide debate.</p> Vasudha Khanna K. Madan Gopal Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1086 1090 10.18203/2320-1770.ijrcog20240822 Tokophobia: a fear of childbirth and pregnancy - an overview <p>Tokophobia is a mental disorder that affects women of all ages and varies from a mild to severe dread of delivery. Knauer first reported in the literature in 1897 that between 20% to 78% of pregnant women experience dread connected to pregnancy and delivery. The International Journal of Reproduction, Contraception, Obstetrics and Gynaecology published a study that found that the prevalence of tokophobia was 30.7% on Levin's scale and 55.3% on Areskog's score. Tokophobia is a multifaceted fear of labor that can be further classified into primary tokophobia and secondary tokophobia. People who have tokophobia may have extreme anxiety that manifests as nightmares, insomnia, panic attacks, and avoidance of situations involving pregnancy or childbirth. The most prevalent type of tokophobia is called secondary tokophobia, and it usually affects women who have already given birth and have experienced a traumatic delivery previously. A 20-item questionnaire called the fear of childbirth questionnaire (FCQ) is used to scale people's fear of giving birth. Cognitive-behavioral therapy (CBT) is mostly used as a non-pharmacological treatment.</p> <p> </p> Mudit Bhardwaj Aashutosh Sinwal Vishv Sagar Sharma Smrithimol Baby Shagun Singh Copyright (c) 2024 International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2024-03-28 2024-03-28 13 4 1091 1097 10.18203/2320-1770.ijrcog20240823