International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Obstructed hemivagina with uterus didelphys and ipsilateral renal anomaly syndrome: a rare presentation with pyocolpos

Thu, 29 Jan 2026 00:00:00 +0530

Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis (OHVIRA syndrome) is a rare congenital anomaly of the female genital tract. It typically presents after menarche with progressive pelvic pain due to hematocolpos formation, leading to dysmenorrhea and a pelvic mass. We report the first documented Lebanese case of OHVIRA syndrome, involving an 18-year-old woman who presented with recurrent pelvic pain particularly during menstruation irregular cycles, and yellowish vaginal discharge. Pelvic ultrasonography, computed tomography, and magnetic resonance imaging confirmed the diagnosis. The distinct rarity of this case lies in the presence of pyocolpos, an uncommoun complication. The patient underwent surgical excision of the obstructing vaginal septum, with drainage of approximately 100 ml of purulent fluid. A Penrose drain was placed within the obstructed hemivagina the first reported use of this technique in Lebanon to ensure continuous drainage and prevent postoperative re-obstruction. The patient experienced complete symptom relief following the procedure.

Importance of medical imaging in ovarian hyperstimulation syndrome post suction and evacuation of H-mole: a rare case report and literature review

Thu, 29 Jan 2026 00:00:00 +0530

Hydatidiform mole (H-mole) is a gestational trophoblastic disorder caused by abnormal fertilization, often presenting with elevated β-HCG levels and abnormal uterine findings. A rare complication is spontaneous Ovarian Hyperstimulation Syndrome (OHSS), usually associated with fertility treatments but occasionally triggered by high endogenous β-HCG levels. We report a case of a 17-year-old primi-gravida who developed OHSS following suction and evacuation of a complete H-mole. Despite of initial management, she presented later with ovarian enlargement, lung nodules, and rising β-HCG, indicating high-risk gestational trophoblastic neoplasia (GTN) for which imaging played a key role in identifying complications. She responded well to EMA-CO chemotherapy with normalization of β-HCG. This case emphasizes the importance of post-evacuation monitoring and the critical role of imaging in diagnosing and managing rare but serious complications like spontaneous OHSS.

Ruptured ectopic pregnancy in a patient on levonorgestrel subdermal implant in-situ: a case report

Weyinmi Kubeyinje, Reuben O. Iweka, Uwadiae Anthony — Thu, 29 Jan 2026 00:00:00 +0530

Ectopic pregnancy is a major cause of first-trimester maternal morbidity and mortality, particularly in low-resource settings where delayed diagnosis often leads to tubal rupture. Although levonorgestrel implants are highly effective, pregnancies that occur in users carry a higher likelihood of ectopic implantation. A 28-year-old Gravida 3 Para 3 presented with severe lower abdominal pain, dizziness, abnormal vaginal bleeding, and eight weeks of amenorrhoea while remaining hemodynamically compensated. A positive pregnancy test, PCV of 26%, and ultrasound showing a right adnexal mass with free fluid confirmed ectopic pregnancy despite recent Jadelle implant reinsertion. Emergency laparotomy revealed 1.5 litres of haemoperitoneum and a ruptured right ampullary ectopic pregnancy, leading to right salpingectomy and uneventful recovery after transfusion. This case highlights how early vital signs may remain deceptively stable despite massive haemoperitoneum, underscoring the need for clinical vigilance. Routine pregnancy testing in all reproductive-age women with abdominal pain is essential, regardless of contraceptive use or recent implant replacement. Ultrasound findings and low PCV provided crucial diagnostic support, while timely surgery and resuscitation were lifesaving. Ectopic pregnancy should always be considered in reproductive-age women presenting with abdominal pain. Early diagnosis and prompt surgical intervention are critical to reducing preventable maternal morbidity and mortality.

Spontaneous ovarian hyperstimulation syndrome following evacuation of a partial mole: a case report

Chandni Sehgal, Sekhar Chakarabarti, Ravmeet K. Sareen — Thu, 29 Jan 2026 00:00:00 +0530

Ovarian hyperstimulation syndrome (OHSS) is usually an iatrogenic complication of ovarian stimulation, while spontaneous OHSS is rare and linked to conditions with high human chorionic gonadotropin (hCG), such as molar pregnancy. Herein, this case reports an 18-year-old woman who developed spontaneous OHSS two months after suction evacuation of a partial mole, presenting with abdominal pain, vomiting, and distension. Her β-hCG had fallen from 59,027 to 1,463 mIU/ml. Ultrasonography showed bilaterally enlarged multicystic ovaries (~8–9 cm), ascites, and an empty uterus; laboratory parameters were normal. Pregnancy, ovarian torsion, and persistent mole were excluded, confirming spontaneous OHSS. She was treated conservatively with cabergoline 0.5 mg daily for 10 days, with resolution of symptoms in 4–5 days, and discharged on combined oral contraceptives. β-hCG remained normal over 2 years of follow-up. This case underscores the rarity of spontaneous OHSS post-molar evacuation and the importance of early recognition and conservative management for favorable outcomes.

Tuberculous cervicitis: a masquerader of malignancy

Thu, 29 Jan 2026 00:00:00 +0530

This case report describes a young woman initially suspected of having cervical malignancy, whose final diagnosis was confirmed by biopsy as tuberculous cervicitis, emphasizing the need for a high index of suspicion and the critical role of histopathology in achieving an accurate diagnosis.

Amniocentesis in DEND syndrome and medical termination of pregnancy: a rare disease

L. Thulasi Devi — Thu, 29 Jan 2026 00:00:00 +0530

An interesting case of DEND Syndrome with history of genetic inheritance and manifestation in the first child. Case is being reported as it is one among the first cases to be confirmed antenatally by Amniocentesis at an obstetric centre in India. Only 60 cases have been reported worldwide as on date as per OMIM database. It has a prevalence of <1: 1000000 worldwide.

A rare case of secondary gynaetresia after face-to-pubes birth managed by vaginoplasty

Ravmeet Kaur Sareen, Payal Anand, Chandni Sehgal — Thu, 29 Jan 2026 00:00:00 +0530

Postpartum vaginal stenosis is an extremely rare but distressing complication following vaginal delivery. We report the case of a 25-year-old para 1 woman who developed secondary gynatresia after a face-to-pubes vaginal delivery complicated by extension of episiotomy and vaginal wall tears. The patient presented two months postpartum with inability to resume sexual intercourse. Examination revealed a fibrous constricting band at the vaginal introitus with markedly reduced vaginal caliber. She was successfully managed with surgical adhesiolysis and vaginoplasty followed by regular postoperative vaginal dilation. Early diagnosis and timely surgical intervention resulted in complete symptomatic relief. This case highlights the importance of careful repair of obstetric lacerations and vigilant postpartum follow-up to prevent long-term sexual morbidity.

Pregnancy outcome in patient with rare autoimmune disease with complex cardiac ailment

Hansika Anuragi, Harsha S. Gaikwad, Kalpana Pandey — Thu, 29 Jan 2026 00:00:00 +0530

Takayasu arteritis (TA), a rare chronic granulomatous vasculitis of the aorta and its major branches, poses significant challenges in pregnancy, including an increased risk of hypertension, pre-eclampsia, intrauterine growth restriction (IUGR), and maternal cardiac decompensation. We present the case of a 22-year-old, G2A1 woman at 38 weeks and 3 days of gestation, with a known history of TA and a blockade of the left main coronary artery requiring stent placement. Her pregnancy was managed by a multidisciplinary team. Antihypertensive therapy (Metoprolol and Torsemide) was carefully titrated, and Ecospirin was discontinued prior to delivery. An elective lower segment caesarean section (LSCS) under invasive haemodynamic monitoring was performed at 38 weeks, resulting in the delivery of a healthy infant and favourable maternal outcome. This case underscores that with meticulous, multidisciplinary antenatal care, strategic medication management, and timed delivery, successful pregnancy outcomes are achievable in women with TA, even with a history of severe coronary involvement. It aligns with literature advocating for individualised care plans in this high-risk obstetric population.

The shoulder’s hidden alarm: metastatic uterine leiomyosarcoma in disguise

Harshitha S., Manjunath, Jennifer B. Stephens, Sushmitha S. — Thu, 29 Jan 2026 00:00:00 +0530

Uterine Leiomyosarcoma is a rare but aggressive soft tissue tumour arising from smooth muscle fibres of the uterus. Leiomyosarcoma is one of the most common types of smooth muscle-derived malignancies in uterus and it is an aggressive malignancy. We are reporting a unique case of a 54-year-old woman who presented with uterine leiomyosarcoma along with humeral metastasis manifesting as a right shoulder swelling, an uncommon site of metastasis. This case report emphasizes the rarity of this presentation and underscores the importance of thorough clinical and radiological evaluations in atypical presentations. This patient also had a significant symptom relief and improvement in quality of life following palliative care and chemotherapy.

Bilateral incidental benign Brenner’s tumors with unilateral mucinous cystadenoma of ovary – a rare case report

Sonal T. Raut, Meera T. P. — Thu, 29 Jan 2026 00:00:00 +0530

Brenner tumors are unilateral and in 5-7% of cases the tumors are bilateral. These tumors are usually identified incidentally during imaging studies or surgery in post-menopausal women. Histologically, BTs are characterized by well-circumscribed nests of transitional epithelium surrounded by a fibromatous background. Brenner tumors are known to coexist with mucinous tumors of ovary. We have presented a rare case in 43-year-old pre-menopausal women presented with heavy bleeding reported as bilateral incidental Brenner’s tumor associated with unilateral mucinous cystadenoma along with other pathologies like benign endometrial polyp, adenomyoma and paratubal cyst. It highlights the awareness for extensive sampling of bilateral ovaries because of the common association with mucinous cystadenomas.

Isolated torsion of paraovarian cyst: a case report with review of literature

Basanta M. Hota, Kavitha Bakshi, Teja R. Pandiri, Devisri Yallamandla — Thu, 29 Jan 2026 00:00:00 +0530

Paraovarian cyst (POC) develops in the mesosalpinx, between the fallopian tube and the ipsilateral ovary. The incidence is 02-03% of adnexal masses and torsion occurs in about 01% of acute abdomen in women with adnexal mass. It is common in reproductive age and originates from the mesothelium or the embryonic remnant of Müllerian or Wolffian duct. The cyst is usually benign, unilateral, sessile, unilocular, small size and asymptomatic. The patient may be asymptomatic or present with chronic pain when a POC increases in size or with an acute abdomen when it develops complications like torsion, hemorrhage, rupture, or malignancy. Diagnosis is difficult, and surgical exploration is the gold standard for diagnosis and management. We present a case of 24-year-old unmarried girl with dull pain abdomen off and-on-and low back pain for three months is more so for last 3 days without gastrointestinal or urinary symptoms or menstrual abnormality. Infective origin was excluded clinically and on blood count. Ultrasound revealed a cystic lesion in the left adnexa likely to be a simple ovarian cyst. She developed acute abdomen features later, and laparoscopy revealed a torsion left POC of 10×10 cm. De-torsion and cystectomy were performed, and histopathology reported a benign POC of paramesonephric origin. Rare incidence and challenging diagnosis must be kept in mind in acute abdomen with adnexal mass, and surgical exploration should not be delayed. The presentation aims to report the rare pathology and Laparoscopy as the gold standard for diagnosis and management.

Serous cystadenoma of the broad ligament mimicking an ovarian cyst: a diagnostic challenge

Anagha B. R., Rachel Mathew — Thu, 29 Jan 2026 00:00:00 +0530

Serous cystadenomas are epithelial tumours which are commonly seen in ovaries. Its occurrence in broad ligaments is extremely rare. The symptoms, signs and ultrasonic appearance of a broad ligament lesions may be difficult to distinguish from an ovarian tumour. So, it is important to keep a differential diagnosis of an extra ovarian lesion in cases of an adnexal mass.

Unveiling a hidden trap: a case of unexpected acardiac twin diagnosed at cesarean section

Thu, 29 Jan 2026 00:00:00 +0530

Twin reversed arterial perfusion (TRAP) sequence is a rare complication of monochorionic twin pregnancies, occurring in 1 in 35,000 births. It is characterized by retrograde arterial perfusion of a malformed acardiac twin by the structurally normal pump twin through placental vascular anastomoses. A 29-year-old primigravida with a monochorionic diamniotic twin pregnancy was diagnosed with a viable Twin A and intrauterine foetal demise of Twin B on early ultrasonography. Serial scans showed progressive anomalies in Twin B, including a large anechoic cranial cyst, overlapping skull bones and diffuse subcutaneous edema. At 28 weeks of gestation, the patient presented with preterm premature rupture of membranes. An emergency caesarean section was performed for cord presentation of Twin A. A 770-gram male twin were delivered and required intensive neonatal support but died on day 2 of life due to multiorgan failure, birth asphyxia and very low birth weight. The acardiac twin weighed 2390 grams with well-formed lower limbs but severely malformed upper body structures. TRAP sequence results from deep placental arterial-to-arterial anastomoses causing reversed blood flow and variable maldevelopment of the acardiac twin. Pump twins, though anatomically normal, are at significant risk of cardiac overload and poor perinatal outcome, especially when the acardiac twin exhibits disproportionately large mass. Minimally invasive foetal therapies such as radiofrequency ablation and high-intensity focused ultrasound have shown improved survival in selected pregnancies. TRAP sequence remains a rare but serious complication with high morbidity and mortality. Early detection, multidisciplinary counselling and consideration of foetal therapy are crucial for optimizing pump twin outcomes.

Laparoscopic management of cesarean scar pregnancy with isthmocele repair using Rahman’s classification and surgical technique: a case report

Hafeez Rahman, Sonia Farhan, Ayesha Taniya — Thu, 29 Jan 2026 00:00:00 +0530

The global increase in caesarean section (CS) rates has resulted in a higher incidence of caesarean scar-related complications such as uterine niche, isthmocele, and caesarean scar pregnancy (CSP). Existing classification systems focus on when to operate rather than how to perform precise surgical repair. We present a case of a 32-year-old woman with a 5-week caesarean scar pregnancy associated with a large isthmocele, diagnosed by transvaginal ultrasound showing a 20×15 mm scar defect with a myometrial thickness of 2 mm. She underwent laparoscopic evacuation of the scar pregnancy followed by isthmocele repair based on Rahman’s classification and surgical technique. Rahman's classification and surgical technique provide a structured approach that addresses both anatomical defects and abnormal mucosa. While this case shows a positive clinical outcome, more validation from deeper research is required before definitive conclusions on recurrence reduction or fertility outcomes can be drawn.

A rare cause of acute abdomen in postmenopausal women: borderline mucinous ovarian tumor with torsion

Tanya Singhal, Satyabhama Marandi, Sugatha Sahu, Keshari Rajmohan Pattayat — Thu, 29 Jan 2026 00:00:00 +0530

Ovarian torsion accounts for 2–3% of gynecological emergencies and is typically associated with benign, mobile ovarian cysts in reproductive-age women. Torsion involving malignant or borderline ovarian tumors is rare, particularly in postmenopausal women, and may obscure timely diagnosis and management. We report a rare case of a 45-year-old postmenopausal woman presenting with acute abdominal pain, nausea, and vomiting. Clinical examination revealed a large, firm abdominopelvic mass with restricted mobility. Ultrasound and contrast-enhanced CT demonstrated a 20 cm multiloculated right ovarian mass with solid components and >270° vascular pedicle torsion, raising suspicion for malignancy. Tumor markers showed normal CA-125 and CEA but elevated CA-19.9. The patient underwent staging laparotomy with total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. Intraoperatively, a 20 cm twisted ovarian mass with areas of hemorrhage and necrosis was identified. Histopathology confirmed a mucinous borderline ovarian tumor with microinvasion, confined to the right ovary (FIGO stage pT1a). The contralateral ovary unexpectedly showed a benign Brenner tumor. Omentum and peritoneal cytology showed no malignant involvement. This case underscores that adnexal torsion in postmenopausal women warrants a high index of suspicion for malignancy. Mucinous tumours may present with normal CA-125 but elevated CA-19.9, particularly in the setting of torsion. Early imaging, comprehensive evaluation, and prompt surgical staging are crucial to prevent complications such as capsular rupture and peritoneal dissemination. Timely management in this case enabled complete oncologic surgery and a favorable postoperative outcome.

Bandl's ring: a comprehensive review

Natalia de J. M. Llamas, Luis Á. V. Aguilera — Thu, 29 Jan 2026 00:00:00 +0530

Bandl's ring is a pathological retraction ring marking the junction between an overstretched upper uterine segment and a thickened, contracted lower segment. It is a critical sign of obstructed labor and imminent uterine rupture. It arises from failure of normal uterine retraction, often due to cephalopelvic disproportion, malpresentation, or macrosomia. Clinically, a late and ominous oblique abdominal groove may be palpable. Diagnosis is primarily clinical, supported by ultrasound showing distorted anatomy and fetal compromise. Immediate cesarean delivery is the definitive and urgent management. Uterine stimulation or instrumental vaginal delivery are absolutely contraindicated. Any delay risks uterine rupture, severe hemorrhage, fetal asphyxia, perinatal death, and maternal morbidity, including hysterectomy. Prevention relies on vigilant labor monitoring and timely intervention for dystocia. Prompt recognition and expedited surgical delivery are essential to prevent catastrophic outcomes.

Artificial intelligence in embryo selection: enhancing precision and overcoming traditional limitations in in vitro fertilization

K. Reshma Reddy, Muhammed Asif, Gunjan Deotale, V. G. Shanmuga Priya — Thu, 29 Jan 2026 00:00:00 +0530

Identification of embryos with the highest potential for successful implantation is a key step in in-vitro fertilization (IVF). Traditionally, embryologists visually grade embryos by assessing their morphology and developmental stages. However, these assessments can differ between embryologists (inter-observer variability) and even when the same embryologist reviews the same embryo again (intra-observer variability), leading to inconsistent grading and potential misjudgement of embryo grading. Recent advancements in artificial intelligence (AI) offer a more standardized and objective approach to human embryo grading. By using machine learning models, AI systems can analyze embryo images and detect subtle developmental patterns that may not be apparent through visual assessment alone. This review explores original research studies from 2012 to 2024, that developed AI-driven embryo assessment methods that apply machine learning models, such as Convolutional Neural Networks (CNNs), which are deep learning models, while excluding studies involving animal embryos and non-english papers. Our findings from the review indicate that AI can reduce human error and improve embryo grading consistency for successful IVF. However, integrating AI into clinical practice presents challenges such as data variability, regulatory barriers, and the need for transparent, explainable AI models. Future directions include refining AI models to handle diverse datasets ensuring model interpretability for clinicians, and validating AI systems through large-scale clinical trials to establish their reliability and clinical utility in embryo selection.

Exploring the efficacy of herbal therapies in treating male infertility: a narrative review

Thu, 29 Jan 2026 00:00:00 +0530

Infertility, defined as the inability to conceive after one year of unprotected intercourse, affects millions worldwide, with male factors contributing to nearly 40% of cases. Lifestyle habits, psychological stress, genetic abnormalities, and environmental exposures are key contributors. In low and middle-income countries, herbal medicines are increasingly used as affordable, accessible alternatives to conventional therapies due to their favorable safety profile. This review synthesizes evidence from in vitro, in vivo, and clinical studies on medicinal plants such as Eurycoma longifolia, Tribulus terrestris, Mucuna pruriens, and Withania somnifera, which have demonstrated potential to promote spermatogenesis, regulate hormones, strengthen antioxidant defenses, and improve sperm quality. Although long employed in traditional systems like Ayurveda, Siddha, and Unani these therapies remain underutilized in modern practice. This review emphasizes the integration of traditional knowledge with contemporary medicine and highlights the need for standardized clinical trials and regulatory frameworks to ensure safety and efficacy. Herbal medicine may serve as a valuable adjunct in improving male reproductive outcomes, bridging historical practice with scientific advances.

The role of physiotherapy in menstrual health: a narrative review

Sayed Arzoo Fatima Mohammed Abbas, Mayuri Khatavkar — Thu, 29 Jan 2026 00:00:00 +0530

The field of menstrual health integrates the various aspects of menstrual cycle to enhance overall functioning and quality of life. Physiotherapy plays a key role by providing a comprehensive, evidence-based approach through conservative management strategies. Literature search was performed in the month of September and October 2025 through major academic databases including PubMed, Scopus, Web of Science and Google Scholar. The research included studies from January 2010 until October 2025. The terms used for the study are "menstrual health" and "dysmenorrhea" and "physical therapy" and "premenstrual syndrome" and "endometriosis" and "chronic pelvic pain" and "therapeutic exercise" and "physiotherapy" to find systematic reviews, meta-analyses and randomized controlled trials (RCTs). Existing evidence indicates that physiotherapeutic methods are safe treatment options that can be used with the conventional medical care. Physiotherapy represents a vital yet underutilized approach in the management of menstrual health. Incorporating accessible physiotherapy services into public health strategies will be helpful in reducing treatment gaps while improving menstrual related health care.

Doppler findings of fetal circulation associated with types of birth and parturients grouped according to Robson’s classification

Metodi E. Trajchevski — Thu, 29 Jan 2026 00:00:00 +0530

Background: Through the detection of the circulatory conditions in the fetus, an insight into the subsequent events during the course and outcome of the pregnancy and birth is possible. The aim of the study was to gain an insight into the Doppler findings from the prenatal investigations and their association with the types of delivery and the ratio between women in from the Robson classification in relation to the studied variables.

Methods: 329 pregnant women at prenatal ultrasound examinations were studied with Doppler assessment of fetal mca(PI) (middle cerebral artery) (pulsatility index), aUPI (umbilical artery) and aUtPI (uterine artery) and followed until delivery when they were grouped according to the Robson classification. Values from Doppler findings as well as data from the current pregnancy and the obstetric history of the included pregnancies were analyzed with statistical tests.

Results: A statistically significant association was established between higher values of mcaPI in fetuses delivered by elective cesarean section and lower values in fetuses delivered vaginally, by emergency cesarean section and elective cesarean section after unsuccessful induction of labor. A significant difference was also shown by the comparison between Robson’s classes.

Conclusions: The Doppler indices of the examined arteries indicating proper fetal circulation were associated with vaginal delivery. Together with the currently confirmed prerequisites for successful induction of labor and vaginal delivery, the findings of fetal circulation studies can serve as an additional parameter for predicting the type of delivery and managing the labor.

Effect of vaginal cleansing with povidone iodine prior to emergency caesarean section on post-operative infectious morbidity in a Nigerian tertiary hospital

Thu, 29 Jan 2026 00:00:00 +0530

Background: Post-caesarean infectious morbidities, including endometritis and wound infections, remain significant contributors to maternal morbidity, particularly in low-resource settings. This study evaluated the effectiveness of preoperative vaginal cleansing with 10% povidone iodine in reducing post-operative infections following emergency caesarean section.

Methods: We conducted a randomized controlled trial involving 266 pregnant women booked for emergency caesarean section randomly assigned to either intervention group with povidone iodine vaginal cleansing (n=133) or control group with no vaginal preparation (n=133). Routine prophylactic antibiotics were administered to all participants. The primary outcome was the incidence of post-caesarean endometritis and the secondary outcome was surgical site infection.

Results: Of the 266 participants enrolled, only 260 were analysed, 37 (14.2%) of whom developed infectious morbidity. Twenty-nine (22.1%) had infectious morbidity in the control group and 8 (6.2%) in the intervention group. Endometritis occurred in 18 (13.7%) of the control and 4 (3.1%) in the intervention group (p=0.01). Wound infection occurred in 11 (8.4%) of the control and 4 (3.1%) in the intervention group (p=0.07). Vaginal cleansing significantly reduced the risk of endometritis [Risk ratios (RR)=0.21, absolute risk reduction (ARR)=0.11; number needed to treat (NNT=9)] and wound infection (RR=0.38, ARR=0.05; NNT=20), with no reported adverse effects.

Conclusions: Preoperative vaginal cleansing with 10% povidone iodine significantly reduced the incidence of post-caesarean endometritis and wound infection. It is a simple, safe, and cost-effective intervention that can improve maternal outcomes, especially in women with prolonged labour or ruptured membranes.

A retrospective cohort study on the outcome of cervical cerclage in patients with recurrent pregnancy loss

Abeer N. Al Hasani, Maryam S. Al Shabibi, Alyia Y. Al Madhani — Thu, 29 Jan 2026 00:00:00 +0530

Background: This study aimed to evaluate pregnancy outcomes after cervical cerclage in patient with recurrent pregnancy loss (RPL). Objectives were to estimate the incidence of cervical cerclage done among patients with history of RPL attending Royal hospital over the last 10 years (2013-2022). And to assess the effectiveness of cervical cerclage done among patient with RPL.

Methods: Retrospective cohort study was conducted. The study was carried out from January 1, 2013, to December 31, 2022, at Royal hospital. All booked pregnant women with history of RPL who had cervical cerclage attending antenatal clinic at Royal hospital during the study period were included in the study. A set of prespecified risk factors (internationally well-known risk factors for cervical incompetence) was identified. Patients were grouped according to the presence or absence of risk factors for cervical incompetence. Both groups were followed up till end of pregnancy.

Results: The overall incidence of cervical cerclage done among patient with RPL was 4.5%. Patient with history of RPL and with nil risk factors for cervical incompetence who had cervical cerclage were 11 patients (10.3%) in compared to other group which were 96 patients (89.7%). History of second trimester miscarriage being the most common risk factor for cervical incompetence (72%), and the least common risk factors were fibroid uterus (2.8%), uterine anomalies (2.8%), PCOS (2.8%) in the study. The rate of live birth after cervical cerclage insertion (elective or rescue) in patients with history of RPL in total was 92.5%. The percentage of neonatal morbidity and mortality was 28.6%. Patients with bulging membranes at the time of cervical cerclage insertion who had live birth were 80% (40% term birth, 40% preterm birth) (p=0.197). Patients with funneling cervix at the time of cervical cerclage insertion who had live birth were 93.8% (68.8% term birth, 25% preterm birth) (p=0.589).

Conclusions: Elective cervical cerclage is recommended in patient with history suggestive of cervical incompetence. As rescue cervical cerclage helped in prolongation of pregnancy till term or late preterm in most of the cases, so cervical assessment is recommended in patients with RPL. Adding progesterone did not show any significant benefit in compared to other group without progesterone, but in view of small sample size further prospective study should be conducted with larger sample size. Screen for genitourinary infections is recommended and to treat accordingly.

Comparison of three sonographic morphology indices and evaluation of its accuracy in predicting ovarian malignancy

Thu, 29 Jan 2026 00:00:00 +0530

Background: Identifying whether an adnexal mass is benign or malignant is crucial because it guides surgeons regarding the type of operative intervention needed. The aim of this study was to evaluate the accuracy of three sonographic morphology indices (DePriest, Sassone, and Ueland) and the risk of malignancy index for preoperative triaging of adnexal masses and comparing their effectiveness in predicting ovarian malignancy.

Methods: A prospective cross-sectional study conducted at Paropakar Maternity and Women’s Hospital from August 2021 to October 2022 underwent an ultrasound scan 48 hours prior to surgery. The specificity, sensitivity, negative predictive value, positive predictive value, and accuracy of all three morphological indices and the risk of malignancy index were calculated and compared.

Results: Among 107 patients, 69 (52.3%) had benign tumors, 11 (8.55%) were borderline, and 27 (20.8%) were malignant. The most common malignant ovarian tumor was serous cystadenocarcinoma (14 cases), followed by immature teratoma (5 cases) and granulosa cell tumor (4 cases). The sensitivity of the DePriest, Sassone, and Ueland morphology indices, along with the RMI, was 77.7%, 73%, 85%, and 65%, respectively. Their corresponding specificities were 82.3%, 86.25%, 78.75%, and 73.7%. In terms of accuracy, DePriest achieved 81.48%, Sassone 83%, Ueland 80.37%, and RMI only 74%.

Conclusions: Although the Ueland morphology index was the most sensitive in predicting ovarian malignancy, the preoperative diagnostic accuracy was similar across all three morphology indices, while it was notably lower for the risk of malignancy index (RMI).

Incidence, clinical profile and maternal–fetal mortality in pregnancies complicated by obstructed labor

Thu, 29 Jan 2026 00:00:00 +0530

Background: Obstructed labour is a significant cause of maternal and fetal morbidity and mortality, particularly in low-resource settings. This study aimed to assess the incidence, clinical profile, and maternal–fetal outcomes in pregnancies complicated by obstructed labour.

Methods: This cross-sectional prospective study was conducted in the Department of Obstetrics and Gynaecology, Sher-e-Bangla Medical College Hospital, Barisal, Bangladesh, from July 2008 to June 2009. This study included 100 patients admitted with obstructed labour across all units of the Obstetrics and Gynaecology Department at Sher-e-Bangla Medical College Hospital.

Results: Most patients were aged 21–30 years (54%) and primigravida (62%). Cephalopelvic disproportion (42%) and persistent occipito-posterior position (28%) were the main causes of obstruction. At admission, 72% were in the second stage of labour, and 54% had labour lasting 25–48 hours. Caesarean section was the predominant mode of delivery (85%). Hypertonic uterine contractions were noted in 46%. Clinically, 59% had raised temperature, 66% had moderate anaemia, and 56% had moderate dehydration. Fetal assessment revealed abnormal or absent heart sounds in 86%, and 91% had meconium-stained liquor. At birth, 43% were stillborn, 38% asphyxiated, and 19% healthy. Genital tract injuries occurred in 27%, predominantly vaginal lacerations (14%). Wound infection (37%), pyrexia (32%), and postpartum haemorrhage (26%) were the main maternal morbidities. Maternal mortality was 3%, while 44% were healthy at follow-up.

Conclusions: Obstructed labour is associated with substantial maternal and fetal morbidity and mortality. Early recognition, timely referral, and appropriate obstetric intervention are essential to improve outcomes.

Emergency contraception: awareness, use and choices amongst antenatal women in a South West Nigeria teaching hospital

Thu, 29 Jan 2026 00:00:00 +0530

Background: Emergency contraception is a worthwhile innovation by all considerations in that it affords women of the opportunity to avert being pregnant even after sexual intercourse had occurred and they do not desire pregnancy or when an on-going contraceptive method is suspected to have failed. The study assessed the level of awareness, level of usage and the choices of emergency contraception among antenatal women.

Method: Women that met the inclusion criteria were serially recruited as they came by convenient sampling method until the required number of 300 which included the allowance for attrition was completed. The questionnaire was administered to the consented patients by antenatal clinic nurses and intern doctors under the supervision of the researchers.

Results: The mean age of the respondents was 34.5±3.2 years. More than half (52.7%) have never used contraceptives before. Almost half of the respondents 51.3% have not had any information about emergency contraceptives The major source of information about emergency contraception for the majority (42.7%) of the respondents was through their friends. Only 18.7% of the respondents have ever used emergency contraceptives before with postinor being the commonest used by 78.6% of them.

Conclusions: It is part of the rights of women to control the number of children they desire and time they desire to give birth to them. There is need to improve on the awareness of emergency contraceptives among the study population in order to prevent morbidity and mortality related to unwanted pregnancy.

Knowledge assessment of healthcare providers and pregnant women on anemia management in selected regions of Ghana

Nicholas Opuni, Victor Collins Wutor, Benoit Banga N’guessan — Thu, 29 Jan 2026 00:00:00 +0530

Background: Anemia in pregnancy is a global health concern, and Ghana, a developing country, is no exception. Overall, it is a significant cause of maternal mortality. This study assessed the effectiveness of hematinic supplements and evaluated healthcare providers’ and pregnant women’s knowledge of anemia in selected regions of Ghana.

Methods: A cross-sectional study was conducted among 470 participants, comprising 329 pregnant women and 141 healthcare providers, across selected hospitals in Ghana’s Central and Greater Accra regions. Data was collected using structured questionnaires and complete blood count (CBC) results. Descriptive statistics and logistic regression were used for analysis.

Results: The prevalence of anemia among pregnant women was 84%, with severity distributions of 43.7% mild, 27.3% moderate, and 13.7% severe cases. Healthcare providers (96.45%) demonstrated a high level of familiarity with hematinics. Among pregnant women, 82.67% showed a good understanding of anemia.

Conclusions: Both healthcare providers and pregnant women demonstrated good knowledge of anemia and hematinic supplementation. These findings support the role of hematinics in the management of anemia during pregnancy, highlighting the need for continued education and early antenatal care.

Association of preoperative inflammatory and nutritional serum markers with post-surgical outcomes in advanced epithelial ovarian cancer patients undergoing primary cytoreductive surgery

Shamim Ara, Jesmin Sultana, Liza Tasrin, Ayesha Siddika Purabi, M. Boyez Uddin — Thu, 29 Jan 2026 00:00:00 +0530

Background: Advanced epithelial ovarian cancer typically presents at later stages, contributing to high morbidity and mortality. Simple, inexpensive biomarkers such as neutrophil-to-lymphocyte ratio (NLR) and serum albumin may help predict postoperative outcomes, particularly in low-resource settings. This study aimed to evaluate the association of preoperative inflammatory and nutritional serum markers with postoperative outcomes among women undergoing primary cytoreductive surgery for advanced epithelial ovarian cancer.

Methods: A descriptive observational study was conducted at Dhaka Medical College Hospital from July 2021 to June 2022, including 50 women with advanced epithelial ovarian cancer undergoing primary cytoreductive surgery. Preoperative NLR and serum albumin were measured and categorized (NLR <3.4 vs ≥3.4; albumin ≥3.5 g/dL vs <3.5 g/dL). Postoperative complications within 30 days and the length of hospital stay were recorded. Statistical analyses included Chi-square tests and t-tests, with p<0.05 considered significant.

Results: Elevated NLR (≥3.4) was significantly associated with higher rates of wound infection requiring secondary suturing and increased postoperative blood transfusion. Similarly, hypoalbuminemia (<3.5 g/dL) was strongly associated with postoperative wound complications and higher transfusion needs. Both elevated NLR and low albumin were significantly correlated with prolonged hospital stay.

Conclusions: Preoperative NLR and serum albumin are valuable predictors of postoperative morbidity and recovery after primary cytoreductive surgery for advanced epithelial ovarian cancer. These readily accessible biomarkers can enhance preoperative risk stratification and guide optimization strategies to improve surgical outcomes.

Antimicrobial susceptibility patterns of uropathogens among pregnant women in Mogadishu, Somalia

Fadumo Elmi Kadiye, Akin Tunde A. Odukogbe, Alem Desta Wuneh — Thu, 29 Jan 2026 00:00:00 +0530

Background: Urinary tract infections (UTIs) are common in pregnancy and pose serious health risks, yet data on uropathogens and antimicrobial resistance (AMR) in Somali pregnant women are limited. This study was carried out to investigate the causative uropathogens, their resistance patterns, and associated factors to multidrug resistance (MDR) among pregnant women at Banadir Maternal and Child Hospital in Mogadishu.

Methods: A cross-sectional study was conducted from August to December 2024 involving 200 pregnant women. Clean-catch midstream urine samples were cultured and tested using standard microbiological methods and antimicrobial susceptibility testing per CLSI 2024 guidelines. Statistical analysis including chi-square and logistic regression was performed to identify predictors of MDR.

Results: Among participants, 38.5% were illiterate, and half were aged between 21 and 25 years. Escherichia coli (59.5%) and Klebsiella spp. (15.5%) were the predominant pathogens. Ciprofloxacin was highly effective against E. coli (94.1%), while nitrofurantoin showed complete efficacy. Klebsiella spp. exhibited high resistance to meropenem (83.8%), gentamicin (80.0%), ceftriaxone (75.0%) and nitrofurantoin (100%). Gram-positive bacteria showed notable β-lactam resistance. UTIs were most common in the second trimester (40%). MDR was observed in 80% of isolates. Primigravida status was strongly associated with MDR, with nearly all primigravida (86.9%) versus few multigravida (3.6%) having MDR infections (AOR=318.25; 95% CI: 27.25-3716.52; p<0.001).

Conclusions: The study underscores the need for routine urine culture, tailored antibiotic therapy, and enhanced surveillance to inform antenatal care and antimicrobial stewardship in Somalia.

Prevalence of preeclampsia and associated factors among pregnant women delivering in Vietnam: a cross-sectional study

Yen Nguyen, Tuan Ho, Hoai-Thanh Lam, Anh Tran, Huyen Pham, Sang Nguyen — Thu, 29 Jan 2026 00:00:00 +0530

Background: Preeclampsia is a leading cause of maternal and fetal mortality and morbidity globally. This study aims to determine the prevalence of preeclampsia and identify associated factors among pregnant women presenting for delivery in Ho Chi Minh City, Vietnam.

Methods: A cross-sectional descriptive study was conducted on 386 pregnant women with a gestational age greater than 20 weeks presenting for delivery in Ho Chi Minh City, Vietnam. Data were collected via direct interviews and medical record reviews. Variables were analyzed using Chi-square and Fisher's exact tests.

Results: The prevalence of preeclampsia in the study group was 2.59% (10/386). Factors showing a statistically significant association (p < 0.05) with preeclampsia included: place of residence (non-urban areas had a higher risk), religion, mode of previous delivery, history of preterm birth, and history of miscarriage. No statistically significant association was found between preeclampsia and age group, occupation, education level, body mass index (BMI), smoking/alcohol habits, or family history.

Conclusions: The prevalence of preeclampsia among pregnant women delivering in Ho Chi Minh City is 2.59%. Identifying associated factors, such as adverse obstetric history and geographical factors, is essential to improve screening and pregnancy management.

Analysis of caesarean section at the University of Benin Teaching Hospital using Robson 10-group classification system: an observational retrospective study

Charles E. Emuze, Reuben O. Iweka, Adedapo B. Ande, Ehigha J. Enabudoso — Thu, 29 Jan 2026 00:00:00 +0530

Background: Caesarean section (CS) refers to the delivery of the foetus, placenta, and membranes through an abdominal and uterine incision. In order to understand the factors responsible for rising CS rate and suggest effective measures to reduce CS rate, it is necessary to have a tool to monitor and compare CS rate in the same setting, over time and between different settings. It has been shown that women-based classification in general and the 10-group classification in particular were best to fulfil current international and local needs. This study aimed to analyse Caesarean sections at the University of Benin Teaching Hospital over one year using the Robson 10 group classification system.

Methods: This is an observational retrospective study at the University of Benin Teaching Hospital (UBTH), Benin City, Edo State, Nigeria. All women who gave birth at UBTH from January 1st 2020, to December 31st 2020, were studied. Data were collected using a proforma, chi-square analysis was done, and a p-value less than 0.05 was considered statistically significant.

Results: The Caesarean section rate during the study period of this was 45.8%. Using the Robson classification system, the highest group of women that delivered during the period was group 3 (multiparous (excluding previous CS), single cephalic, ≥/37weeks in spontaneous labour), followed by Group 5 (all multiparous with at least 1 previous CS, single cephallic, ≥/37weeks) and Group 4 (multiparous, excluding previous CS), single cephallic, ≥/37weeks, induced or pre labour CS). The highest contributing group to CS rate was Group 5, followed by Group 2 (nulliparous, single cephallic, ≥/37weeks, induced or pre labour CS), Group 10 (all women with a single cephallic pregnancy, <37 weeks, including women with previous CS(s)) and Group 4. Groups 8 (all women with multiple pregnancies, including women with previous CS(s)),10 and 7 (all multiparous women with a singleton breech pregnancy, including women with previous CS(s)) had the highest contribution to stillbirth and babies with 5^th minute APGAR less than 7.

Conclusions: The study revealed a high CS rate in UBTH, with Robson Groups 5,10 and 2 accounting for a large percent of the CS rate during the study period. Effort should be targeted at reducing primary CS rate by reducing the incidence of failed IOL in nulliparous to the barest minimum, appropriate monitoring of labour to reduce the incidence of positional CPD, increased utilization of alternative to CS section, such as instrumental delivery and external cephalic version when they are indicated. The trend of increasing utilization of CS for indications that is not purely obstetric, such as maternal request, should be discouraged.

Performance of CT scan in predicting the feasibility of primary optimal cytoreduction in ovarian cancer

Liza Tasrin, Jesmin Sultana, Shamim Ara, Ayesha Siddika Purabi — Thu, 29 Jan 2026 00:00:00 +0530

Background: Ovarian cancer is frequently diagnosed at an advanced stage and optimal cytoreduction remains the most important prognostic factor for survival. Accurate preoperative assessment is essential to identify patients who are likely to benefit from primary debulking surgery. This study evaluated the diagnostic performance of CT scanning and a structured CT scoring system in predicting optimal cytoreduction among women with suspected ovarian cancer. This study aimed to assess the accuracy of preoperative CT findings and total CT score in determining the feasibility of optimal cytoreduction.

Methods: This prospective observational study was conducted at Gynecological Oncology Unit, Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh, from July 2021 to June 2022. Fifty patients with suspected ovarian cancer underwent contrast-enhanced CT scanning before primary cytoreductive surgery. Five CT parameters were evaluated and assigned scores from 0 to 2, producing a total CT score ranging from 0 to 10. CT findings were compared with peroperative findings and histopathology. Diagnostic performance, associations between CT score and surgical outcome were analyzed using SPSS.

Results: Optimal cytoreduction was achieved in 70% of patients. CT showed high sensitivity for ascites, omental involvement, peritoneal thickening and lymph node metastasis. Increasing CT score correlated with a higher likelihood of suboptimal cytoreduction. A CT score ≥3 demonstrated a specificity of 100% and a significant association with suboptimal debulking.

Conclusions: Preoperative CT assessment, particularly total CT score, is a valuable tool for predicting optimal cytoreduction and guiding treatment decisions in ovarian cancer.

Awareness and uptake of cervical cancer screening services among female nurses in a low-resource setting: a cross-sectional study

Thu, 29 Jan 2026 00:00:00 +0530

Background: Despite the high burden of cervical cancer in Nigeria, the uptake of screening services has remained poor even among healthcare workers. This study aimed to determine the awareness, uptake and factors influencing the uptake of cervical cancer screening among female nurses in Federal Medical Centre Asaba.

Methods: A cross-sectional study was conducted between 1^st October and 31^st October 2023 amongst 247 consenting female nurses at FMC Asaba using semi-structured, self-administered questionnaires with 205 correctly filled forms retrieved from the study participants. Data were analysed using SPSS 26 with a p value <0.05 considered significant.

Results: About 96.6% of female nurses were aware of screening for cervical cancer. However, only 28.9% of these nurses have been screened at least once for cervical cancer despite being aware of the availability of such screening modality at their workplace. Poor knowledge, fear of complications, cost of screening and lack of spare time, were some of the identified factors limiting the uptake of cervical cancer screening. There was also a significant association between the level of education and uptake of cervical cancer screening.

Conclusions: This study revealed a low uptake rate of cervical cancer screening among Nurses who should help in the dissemination of the cervical cancer message. These findings are an eye opener for Government at all levels, policy makers, hospital managements and professional bodies.

Correlation of anterior vaginal wall prolapse and lower urinary tract symptoms

Sanyukta Rajbhanadary, Madhu Shrestha, Ganesh Dangal, Samridhi Basnet — Thu, 29 Jan 2026 00:00:00 +0530

Background: The mechanism of lower urinary tract dysfunction due to anterior vaginal wall prolapse has not been fully understood. There have yet to be any definitive studies in Nepal. The aim of our study was to determine the correlation between the anterior vaginal wall prolapse and presence and severity of lower urinary tract symptoms.

Methods: A cross-sectional observational study was conducted in the department of obstetrics and gynecology at Paropakar Maternity and Women’s Hospital. Eighty women aged ≥18 years with anterior vaginal wall prolapse were enrolled. Prolapse was staged (1-4) using the pelvic organ prolapse quantification (POP-Q) system and LUTS were assessed using international consultation on incontinence questionnaire-female lower urinary tract symptoms (ICIQ-FLUTS) long form questionnaire and categorized as storage, voiding, or stress urinary incontinence (SUI) symptoms. Association was calculated using Chi-Square Test and Fisher Exact Test and Spearman’s rank correlation.

Results: Among the 80 patients with anterior vaginal prolapse, 15 (18.8%) were POP-Q stage 1, 30 (37.5%) were POPQ stage 2, 24 (30%) were POP-Q stage 3 and 11 (13.8%) were POP-Q stage 4. 61 (76.3%) women had storage symptoms, SUI in 35 (43.8%) and voiding symptoms in 25 (31.3%) women. Stage I anterior vaginal wall prolapse was significantly associated with SUI (p=0.04). Menopausal status of women was also found to be significantly associated with the storage symptoms (p=0.032).

Conclusions: Our study demonstrated that stage I anterior vaginal wall prolapse was significantly associated with stress urinary incontinence (SUI), Also, menopausal status was found to be independently associated with the storage symptoms.

Beyond perceptions: evaluating South Asian background and its association with obstetric outcomes

Thu, 29 Jan 2026 00:00:00 +0530

Background: Perineal lacerations are common complications of vaginal delivery and can lead to pain, infection, incontinence, dyspareunia, and impaired pelvic floor function. These injuries occur more often after operative vaginal deliveries (OVDs). Clinicians at St. Joseph’s Medical Center (SJMC) raised concerns that severe third- and fourth-degree lacerations may be higher than expected and disproportionately affect South Asian women, a population that may be at increased risk of obstetric anal sphincter injuries (OASIs) due to shorter perineal body length and unique pelvic anatomy.

Methods: A retrospective review of 937 randomly selected delivery records from 2018–2025 at SJMC in Stockton, California was conducted. Ethnicity was verified by chart review and patients were contacted when necessary, and data was stratified by ethnicity to evaluate associations with caesarean delivery, OVDs, and perineal lacerations.

Results: South Asian women accounted for nearly 40% of all caesarean deliveries, over 40% of OVDs and perineal tears. Notably, of the Asian population group, South Asians experienced 100% of the severe 4^th degree perineal tears reported. And, from the entire eligible study population, South Asians contributed to nearly 17% of severe perineal tears.

Conclusions: Although provider bias persists in viewing South Asian women as higher risk, the data suggest SJMC obstetricians maintain low overall adverse outcomes while identifying a subgroup that may benefit from further study.

Prevalence of pregnancy-related low back and pelvic girdle pain among women under antenatal care: insights from an Accra metropolitan survey

Thu, 29 Jan 2026 00:00:00 +0530

Background: Pregnancy-related low back pain (LBP) and pelvic girdle pain (PGP) are common health issues with a high global prevalence. Despite its appalling morbidity, there is no discernible epidemiological data on the population in the context of Ghana. Thus, this study aimed to determine the prevalence of pregnancy-related LBP and PGP during antenatal care within the Accra Metropolis of Ghana.

Methods: Pregnant women attending the antenatal clinics of three selected hospitals within the Metropolis were enrolled in the cross-sectional survey using a non-probability proportional quota sampling method. A data-capturing form, the numeric pain rating scale (NPRS), and the Oswestry disability index were incorporated into the Kobo Toolbox software and administered electronically.

Results: The mean age of the 574 respondents was 28.5 (SD: ±5.68), and the respective prevalence of LBP and PGP were 51.4% (n=295) and 49.3% (n=283). Also, 62.0% (183) and 51.6% (146) of those with LBP and PGP rated their pain as moderate, respectively, on the NPRS. Generally, 153 (62.5%) rated their disability as moderate. Gestational age was strongly associated with the occurrence of LBP (χ²=36.7, df=2, p<0.001) and PGP (χ²=30.6, df=2, p<0.001). Pregnant women in their third trimester have higher odds of experiencing LBP (OR=3.84, p<0.001) and PGP (OR=3.6, p<0.001).

Conclusions: The survey findings indicate a high prevalence of pregnancy-related LBP and PGP, which tends to be strongly associated with gestational age. Thus, healthcare providers should remain vigilant about these disorders during the later stages of pregnancy.

Comparative study of adnexal mass among ultrasonographic findings, perioperative findings and histopathological findings

Ayesha Siddika Purabi, Shamim Ara, Liza Tasrin, Jesmin Sultana — Thu, 29 Jan 2026 00:00:00 +0530

Background: Adnexal malignancy is a significant diagnostic challenge in gynaecology and is the third most common cancer of the female genital tract after cervical and endometrial cancer. Accurate preoperative characterization of adnexal masses is crucial for appropriate management, surgical planning and patient referral. Ultrasonography is widely used as a first-line imaging modality because of its accessibility and low cost. This study aimed to assess the diagnostic correlation among ultrasonographic, peroperative and histopathological findings in adnexal masses.

Methods: This prospective cross-sectional observational study was conducted at the Gynaecological Oncology Unit of Dhaka Medical College Hospital, Bangladesh, from July 2021 to June 2022. Seventy female patients aged 14-75 years with sonographically detected adnexal masses who underwent surgery were included. Ultrasonographic morphological features were evaluated preoperatively, intraoperative findings were documented and histopathology was used as a reference standard. Data were analyzed using SPSS version 23.0.

Results: The mean age of the participants was 41.6±19.5 years and 65.7% were premenopausal. Ultrasonography classified 64.3% of masses as benign and 35.7% as malignant, whereas histopathology confirmed 68.6% of masses as benign and 31.4% as malignant. Ultrasonography demonstrated a sensitivity of 90.9%, specificity of 89.6% and overall accuracy of 90.0% compared with histopathology. Per-operative assessment showed comparable diagnostic performance.

Conclusions: Ultrasonography is a reliable, sensitive and specific modality for preoperative evaluation of adnexal masses. Its effective use can facilitate early diagnosis, improve clinical decision-making and potentially enhance survival outcomes through timely and appropriate treatment.

Study of the effect of vitamin D supplementation on the clinical, metabolic, and hormonal profile of women with polycystic ovary syndrome in walled city of Delhi

Sangita N. Ajmani, Ankita Singh, Anjali Mathur — Fri, 16 Jan 2026 00:00:00 +0530

Background: Polycystic ovary syndrome (PCOS) is a ubiquitous endocrine disorder often associated with vitamin D deficiency, which may contribute to reproductive and metabolic disturbances. This work gauged the influence of vitamin D supplementation on the clinical, metabolic, hormonal, and sonographic profiles of women having PCOS.

Methods: A hospital-based case control study initially included 60 women diagnosed with PCOS. The final sample size was 56, as two participants in the case group conceived, one in the control group conceived, and another control participant was lost to follow-up. The remaining 56 women were equally divided into two groups: cases (receiving metformin 500 mg BD for 12 weeks + vitamin D 60,000 IU once weekly for 12 weeks with advice for lifestyle and dietary modification) and controls (receiving metformin 500 mg BD for 12 weeks with advice for lifestyle and dietary modification). Clinical symptoms, menstrual patterns, and metabolic, hormonal, and sonographic parameters were evaluated before and after the intervention.

Results: Vitamin D supplementation significantly improved infrequent menses (78.6% to 46.4%, p=0.027) and scanty menses (50% to 21.4%, p=0.048) compared to controls. Weight gain reduced markedly in cases (71.4% to 25%, p=0.0013). Significant reductions were observed in fasting glucose (p=0.001) and postprandial glucose (p=0.022), with high density lipoprotein (HDL) showing a significant rise (p<0.001). Hormonal parameters showed no significant changes. Right ovarian volume decreased modestly (p=0.046).

Conclusion: Vitamin D supplementation in PCOS women improved menstrual regularity, weight-related symptoms, glycaemic control, HDL cholesterol, and ovarian morphology, but had limited effects on hormonal parameters.

Gestational weight gain and its association with birth outcomes among pregnant women attending a tertiary care hospital in Eastern India

Mahesh Rath, Subhashree Das, Annwesha Jena, Saroja Subhrayotsna — Fri, 09 Jan 2026 00:00:00 +0530

Background: Gestational weight gain (GWG) is an important determinant of maternal and neonatal outcomes. Both inadequate and excessive GWG are associated with adverse birth outcomes. Objectives were to assess GWG and examine its association with selected birth outcomes.

Methods: A hospital-based prospective observational study was conducted among 220 pregnant women attending a tertiary care hospital in Eastern India. GWG was classified as per institute of medicine guidelines and birth outcomes were analyzed.

Results: Inadequate GWG was significantly associated with low birth weight and preterm delivery, while excessive GWG was associated with macrosomia and increased caesarean section rates.

Conclusions: Suboptimal GWG is significantly associated with adverse birth outcomes.

A study on prevalence of endometrial tuberculosis in unexplained infertility using cartridge-based nucleic acid amplification test

Ekta Basera, Radha Rastogi, Lalita Solanki — Tue, 13 Jan 2026 00:00:00 +0530

Background: Infertility is clinically defined as the inability to achieve pregnancy following one year of regular, unprotected intercourse. Its prevalence exhibits considerable variation across different regions, ranging between 5% and 20%. Extensive research has identified multiple etiological factors contributing to female infertility, including ovulatory dysfunction, infections of the genital tract, tubal obstruction, uterine abnormalities, endometriosis, endocrine disorders, and pelvic inflammatory diseases.

Methods: The study was conducted in the Department of Obstetrics and Gynaecology at RNT Medical College and Allied Hospitals, Udaipur from January 2024 to December 2024, in collaboration with the Department of Microbiology.

Result: Study finding shows that cartridge-based nucleic acid amplification test (CBNAAT) performed on endometrial samples. CBNAAT positivity was observed in 2 out of 70 women (2.86%), while 97.14% tested negative. The detected prevalence aligns closely with global estimates of genital tuberculosis in infertility, reinforcing the value of CBNAAT as a sensitive diagnostic tool in detecting paucibacillary forms of endometrial tuberculosis that might otherwise go undiagnosed through conventional methods.

Conclusion: Study concludes a low prevalence, underscoring that genital tuberculosis may not be a frequent cause in cases labelled as unexplained infertility. While CBNAAT demonstrated high specificity (approaching 100%), its sensitivity remains low (around 22–25%), indicating that although a positive result strongly confirms disease, a negative result does not reliably exclude it.

Study of correlation of clinical and laparohysteroscopic diagnosis among infertile patients

Aakanksha Arrawatia, Shilpa Naik — Thu, 29 Jan 2026 00:00:00 +0530

Background: To find the prevalence of infertile patients during the study duration of 24 months. To study the indications and findings of diagnostic hysteroscopy and laparoscopy and to correlate the laparo-hysteroscopy findings with the clinical diagnosis of the patients.

Methods: Hospital based observational cross-sectional type of study for a duration of 24 months. 80 infertility patients in between the age of 18-40 years who underwent laparo-hysteroscopy were selected. Descriptive statistical analysis was carried out in the present study. Data analysis done by using SPSS (Statistical Package for social sciences) version 25:0. Using KAPPA statistics significance was assessed as 5% level of significance.

Results: Pre valance of infertile patients during the study duration was 6.06%. Majority of patients (34) 42.5% were in age group 26-30 years. 80% of patients had primary and 20% had secondary infertility. 43 patients i.e. 53.75% of study patients had some abnormal findings which were diagnosed with the help of laparoscope. Maximum patients had pelvic pathology (endometriosis) as an abnormality constituting 20% of the study group followed by 15% of tubal pathology.

29 patients i.e. 36% of study patients had some abnormal findings which were diagnosed with the help of hysteroscope. 11 (13.75%) patients had synechiae followed by 10 patients i.e. 12.5% had intrauterine septum on hysteroscopy.

Conclusions: Laparo-hysteroscopy has proved to be an effective, safe and minimally invasive tool in evaluation and treatment of infertile patients.

Robot assisted hysterectomy - its benefits and advantages over other routes of hysterectomies: a retrospective cohort study

C. P. Dadhich, Nidhi Mehta, Tripti Dadhich, Surmil Sharma, Shweta Mangal — Thu, 29 Jan 2026 00:00:00 +0530

Background: Minimally invasive hysterectomy has become the preferred approach for benign gynecological conditions. Robot-assisted laparoscopic hysterectomy (RALH) has been introduced to overcome certain technical limitations of conventional laparoscopy.

Methods: This retrospective cohort study included 165 women undergoing hysterectomy for benign gynecological indications at a tertiary care center between November 2023 and February 2024. Patients underwent RALH, total laparoscopic hysterectomy (TLH), total abdominal hysterectomy (TAH) or vaginal hysterectomy (VH). Perioperative outcomes including operative time, estimated blood loss (EBL), length of hospital stay (LOS), postoperative pain scores (VAS) and complications were compared.

Results: Of the 165 cases, 43 underwent RALH, 64 TLH, 26 TAH and 32 VH. Baseline demographic parameters were comparable across groups. RALH was associated with significantly lower mean blood loss (8.49±5.51 ml), shorter hospital stay (1.3±0.4 days) and lower postoperative VAS scores compared to other routes (p<0.001). No conversions to laparotomy were required. Secondary hemorrhage was least frequent in the RALH group.

Conclusions: Robot-assisted hysterectomy demonstrates favorable perioperative outcomes in selected patients with benign gynecological conditions. While clinical differences were statistically significant, their impact should be interpreted in the context of patient selection and resource availability.

Study of the association of pregnancy unique quantification of emesis score with adverse feto-maternal outcomes in pregnancy: a prospective observational cohort study

Monika Nautiyal, Shalini Warman, Ojasvi Shanker — Thu, 29 Jan 2026 00:00:00 +0530

Background: Nausea and vomiting of pregnancy (NVP) affect up to 80% of gestations, ranging from mild discomfort to severe hyperemesis gravidarum. While often dismissed as a benign condition, NVP may be linked to significant adverse feto-maternal outcomes. This prospective study evaluated the clinical utility of the pregnancy-unique quantification of emesis (PUQE-24) scoring system as a prognostic tool for predicting complications among 300 pregnant women at a tertiary care hospital in Eastern India.

Methods: This prospective observational study (April 2023–March 2025) categorized 300 first-trimester participants into mild (≤6), moderate (7–12), and severe (13–15) NVP groups using the PUQE-24 scale. Demographic data, clinical markers (ketonuria, liver enzymes), and hospitalization metrics were documented. All participants were followed through delivery to record maternal outcomes (anemia, GDM, and hypertension) and fetal outcomes (birth weight and gestational age).

Results: NVP was classified as mild (46.3%), moderate (35.0%), and severe (18.7%). Severe cases showed significant correlations with maternal age ≤30 years. 100% of severe cases required hospitalization (mean 4.4 days) with an 83.9% readmission rate. Severe NVP also demonstrated significantly higher rates of anemia (78.6%), GDM (58.9%), preterm delivery (83.0%), and low birth weight (94.3%) compared to mild cases.

Conclusions: The PUQE-24 score is a vital prognostic tool. Strong associations between NVP severity and adverse outcomes like preterm birth and fetal growth restriction necessitate early standardized assessment and targeted intervention, especially in resource-limited settings.

Phenotypic spectrum of polycystic ovary syndrome in a tertiary care rural hospital in Eastern India

Thu, 29 Jan 2026 00:00:00 +0530

Background: PCOS is a common, complicated endocrine disorder affecting women of reproductive age causing wide-spectrum of clinical, metabolic and hormonal abnormalities whose characteristics are poorly understood. This research will investigate the phenotypic prevalence of PCOS as well as clinical, hormonal and metabolic aspects to identify risks and therapeutic requirements.

Methods: The Rotterdam criteria were used to classify 204 women with PCOS into four phenotypes: A (hyperandrogenism + oligo/anovulation + polycystic ovaries), B (hyperandrogenism + oligo/anovulation), C (hyperandrogenism + polycystic ovaries) and D (oligo/anovulation + polycystic ovaries). BMI, waist circumference, hip circumference, waist-to-hip ratio and clinical features (menstrual abnormalities, acanthosis nigricans) were examined. To compare the phenotypes, luteinizing hormone, follicle-stimulating hormone, testosterone and metabolic indicators (lipid profiles, glucose metabolism parameters) were examined. The phenotypes were also examined for the prevalence of metabolic syndrome.

Results: A (58.33%) was the most prevalent phenotype, followed by D (32.84%), C (4.90%) and B (3.43%). Phenotype A had the highest BMI and most menstrual abnormalities and also the highest LH/FSH ratio and the highest testosterone, indicating a severe endocrine disorder. Phenotype A also had the worst lipid profile and the highest metabolic syndrome (24.37%).

Conclusion: Phenotype A is the most severe form of PCOS, characterized by clinical, metabolic and hormonal abnormalities and increases the risk of cardiovascular and metabolic problems. These data suggest that PCOS therapy should be phenotype-specific to address the risks and health problems of each phenotype and treatment individualised.

Comparison of prophylactic versus regular use of antibiotics in caesarean section

Umesh Maruti Jirange, Y. Sneha, P. P. S. Mallika — Thu, 29 Jan 2026 00:00:00 +0530

Background: Surgical site wound infections and associated complications after caesarean delivery are important causes of maternal morbidity, increased duration of hospital stay and cost of treatment. Prophylactic antibiotic usage decreases the risk of these wound infections. Because of variations in patient profiles and a lack of knowledge regarding asepsis, clinicians are reluctant to implement the recommended single-dose preoperative antibiotic prophylaxis.

Methods: This was a prospective study involving 200 women undergoing caesarean delivery at obstetrics and gynecology department of MNR Medical College and Hospital, Fasalwadi, Sangareddy, tertiary care centre. Eligible participants were divided into two groups. Group A received single dose antibiotic prophylaxis of ceftriaxone 1 gm intravenously 30-40 minutes before caesarean section and group B received cefotaxime 1 gm +sulbactam 500 mg 30-40 minutes before the caesarean, followed by cefotaxime+sulbactam and ornidazole intravenously for the first 3 post-operative days followed by oral cefixime for the next 5 days. Postoperatively, both groups of patients were followed up for febrile morbidity, UTI, wound infection, vaginal infection. These parameters were compared across the two groups.

Results: There were 100 patients in each group. Baseline characteristics, indications for caesarean delivery, operative duration and difficulties were similar. Post-operative morbidities like fever did differ significantly, UTI, wound infection, vaginal infection did not differ significantly. Few of the women needed prolongation of hospital stay.

Conclusions: Preoperative prophylactic antibiotic regimen was as effective as regular antibiotic regimen prophylaxis for routine caesarean delivery. Judicious use of limited antibiotics should be encouraged to decrease antibiotic resistance, with the added benefit of being economical.

Assessment of the efficacy of biodegradable sanitary pads: a cross-sectional survey study among college students and staff at South Goa

Anura Bale, Geeta Patki, Madhuri Lotliker, Gandhali Upadhye — Thu, 29 Jan 2026 00:00:00 +0530

Background: Menstruation is an absolute physiological event. Menstrual management program is a wide concept worldwide. Many aids are presently available in the market too. Each one has its own positive and negative impacts. Biodegradable sanitary napkins have sparked interest in theo- thinkers as well as users. However, limited research exists on the effectiveness of biodegradable sanitary napkins. Understanding this purview, a study was conducted with the aim to evaluate the effectiveness of biodegradable sanitary napkins among the youngsters.

Methods: A cross-sectional survey was conducted among 150 female college students, along with staff from the reproductive phase, who were willing to participate. Participants provided feedback on their experiences with biodegradable sanitary napkins. Females who were known cases of genital infections were excluded from the study. After verbal consent subjects were enrolled in the study. Collection of data was done through Google forms with consent.

Results: The study concluded that 68.7% females managed their menstrual flow with these sanitary pads and also indicated that the use of sanitary pads 94.7% subjects did not experience any allergy.

Conclusions: The findings of this survey of biodegradable sanitary pads revealed overall satisfaction and minimal side effects. The study also indicated a need for product innovation in comfort, skin safety, and flow management.

Histopathological insights into treatment failure with the levonorgestrel releasing intrauterine system in women with heavy menstrual bleeding: a retrospective study

Saroj Kumari, Nigamananda Mishra, Siddhi A. Kode — Thu, 29 Jan 2026 00:00:00 +0530

Background: The levonorgestrel-releasing intrauterine system (LNG-IUS) is an established first-line therapy for heavy menstrual bleeding (HMB), effectively reducing menstrual blood loss and improving quality of life in most women. However, a subset of patients fails to achieve adequate response, warranting evaluation of potential underlying causes.

Methods: This retrospective study was conducted at BARC Hospital, Mumbai, from January 2017 to March 2020, and included 88 women with HMB treated with LNG-IUS. Non-responders were identified based on persistent heavy bleeding despite therapy. Endometrial biopsy and, where applicable, hysterectomy specimens were analyzed to determine histopathological findings associated with treatment failure.

Results: Of the 88 women treated, 26 (29.5%) were classified as non-responders. Endometrial biopsy revealed proliferative endometrium in 65.4%, disordered proliferative endometrium in 19.2%, and secretory endometrium in 15.4% of cases. Among nine non-responders who underwent hysterectomy, adenomyosis was the most common finding (44.4%), followed by adenomyosis with leiomyoma (33.3%), endometrial polyp (11.1%), and leiomyoma (11.1%).

Conclusions: Treatment failure of LNG-IUS in women with HMB was predominantly associated with structural uterine abnormalities, particularly adenomyosis. Comprehensive pre-insertion evaluation, including clinical and imaging assessment, is essential to detect underlying pathology and optimize patient selection. Individualized management based on uterine morphology and symptom profile may improve therapeutic success and reduce delays in achieving symptom control.

Association between trigger-intrauterine insemination interval, ovulation trigger agent, and clinical pregnancy in intrauterine insemination cycles: a 300-case analysis

Aananathalakshmi B., Akila Vaidyanathan, Chitra Santanagopalan, Enitha Kuppuraj — Thu, 29 Jan 2026 00:00:00 +0530

Background: Intrauterine insemination (IUI) is a commonly employed first-line treatment for couples with unexplained infertility and mild male factor infertility due to its simplicity, low cost, and minimal invasiveness. Ovulation is typically induced using pharmacological triggers to allow accurate scheduling of IUI either with human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone (GnRH) agonists. While insemination is commonly performed between 24 and 40 hours after the trigger, studies have reported variable pregnancy rates across different timing intervals, and no universal consensus has been established. Given these uncertainties, further evaluation of both the timing of insemination and the choice of ovulation trigger is warranted. Hence this study aims to assess how the interval between ovulation trigger and IUI influences clinical pregnancy outcomes, and to compare pregnancy rates between cycles using a GnRH agonist versus hCG as the trigger.

Methods: A retrospective analysis was conducted on 300 IUI cycles performed at Janani Fertility Centre, Trichy, Tamil Nadu. Eligible cases included couples with unexplained infertility, male partners aged 23–40 years, and female partners aged 22–38 years with bilaterally patent fallopian tubes. Cycles with abnormal semen parameters, incomplete or frozen samples, double IUI, or donor sperm use were excluded. Patients were grouped according to the interval between trigger administration and IUI: <36 hours (group A, n=70), 36–38 hours (group B, n=140), and >38 hours (group C, n=90). Trigger type was hCG (n=187) or GnRH agonist (n=113). Categorical variables were analyzed using the Chi-square test.

Results: Clinical pregnancy rates differed significantly across timing groups: group A: 8.6%, group B: 25.7%, and group C: 15.6%. The highest pregnancy rate occurred when IUI was performed 36–38 hours after the ovulation trigger. Trigger comparison showed higher pregnancy rates with hCG (25%; 47/187) than with GnRH agonist (8%; 9/113).

Conclusions: IUI performed 36–38 hours after ovulation trigger is associated with the highest likelihood of clinical pregnancy, indicating optimal synchronization of ovulation and insemination at this interval. Additionally, hCG appears more effective than GnRH agonist as a trigger for improving pregnancy outcomes in IUI cycles.

Yoga as a therapeutic modality for hormonal and metabolic regulation in premenopausal women with polycystic ovary syndrome

Ranjane Kumaravelu, Bhartahi Dhevi V. R. — Thu, 29 Jan 2026 00:00:00 +0530

Background: Polycystic ovary syndrome represents a significant health challenge for women during the premenopausal phase, characterized by hormonal imbalances, metabolic dysfunction, and chronic inflammation. Traditional pharmacological approaches often provide incomplete relief and may be associated with unwanted side effects. This investigation examined yoga practice as a non-pharmacological therapeutic strategy for addressing the multidimensional pathophysiology of PCOS.

Methods: Forty premenopausal women aged 35-55 years diagnosed with PCOS participated in this three-month randomized controlled investigation at GVN Hospital, Trichy, Bangalore. Participants were allocated to control (n=10) and yoga intervention (n=30) groups. The yoga protocol consisted of structured 30-minute sessions held three times per week, incorporating physical postures, breathing techniques, and meditation. Comprehensive assessments included reproductive hormone profiles, inflammatory biomarkers, metabolic parameters, and clinical outcomes.

Results: Participants engaging in yoga interventions demonstrated substantial improvements across multiple physiological domains. Significant reductions were observed in high-sensitivity C-reactive protein and interleukin-6 levels, indicating decreased systemic inflammation. Hormonal assessments revealed favorable changes in luteinizing hormone, estradiol, and prolactin concentrations. Metabolic indices showed improvement, with enhanced insulin sensitivity and reduced markers of metabolic dysfunction. Enhanced pregnancy rates were observed among participants seeking conception.

Conclusions: A structured 12-week yoga intervention effectively modulates hormonal balance, reduces inflammatory burden, and improves metabolic health in premenopausal women with PCOS. These findings support yoga as a valuable complementary therapeutic approach that addresses multiple pathophysiological aspects of the syndrome, offering a holistic, sustainable, and patient-centered management strategy for women with PCOS.

Uterine artery diastolic notch and S/D ratio as early markers for predicting neonatal morbidity in patients with hypertensive disorders of pregnancy

Thu, 29 Jan 2026 00:00:00 +0530

Background: Hypertensive disorders of pregnancy (HDP) affect 5-10% of pregnancies globally and are major contributors to neonatal morbidity. This study evaluated the correlation between Doppler indices of the uterine (UtA), umbilical (UA), and middle cerebral (MCA) arteries and fetal outcomes in HDP.

Methods: This prospective observational study, conducted at a tertiary care center in south Gujarat from September 2023 to February 2025, enrolled 138 pregnant women with a gestational age beyond 28 weeks diagnosed with HDP. Doppler indices, including the systolic/diastolic (S/D) ratio, resistance index (RI), and pulsatility index (PI), were recorded for the UtA, UA, and MCA.

Results: Preeclampsia was the most frequent diagnosis (53.6%). The UtA S/D ratio and the presence of a diastolic notch were significantly associated with neonatal morbidity (p=0.01), whereas UtA PI and RI were not significant predictors. All UA and MCA indices showed significant correlations with adverse outcomes (p=0.01). Notable outcomes included 63.04% low birth weight, 57.25% NICU admissions, and 10.8% neonatal deaths. The UtA notch achieved a diagnostic accuracy of 75.36%.

Conclusions: Abnormal Doppler indices, specifically in the UA and MCA, are reliable markers for predicting neonatal risk. Routine triple-vessel Doppler screening is recommended for early risk stratification and timely intervention in HDP.

Study of hysterosalpingography and fallopian tube recanalization in evaluation and treatment of infertile female in tertiary care center: prospective observational study

Ashish Zarariya, Kajal Lanjewar — Thu, 29 Jan 2026 00:00:00 +0530

Background: Infertility affects about 10-15% of couples, with tubal factors contributing to nearly one-third of female infertility cases. HSG remains the first-line imaging modality for evaluating uterine and tubal pathology, while FTR provides a minimally invasive treatment for proximal tubal block.

Methods: This prospective cross-sectional observational study was conducted in the department of obstetrics and gynecology, Government Medical College, Nagpur, over 18 months (January 2023-June 2024). Sixty infertile women meeting inclusion criteria were evaluated using HSG. Cases with proximal tubal block were selected for FTR. Data were analyzed using SPSS version 21, with p<0.05 considered statistically significant.

Results: The mean age of participants was 29.03±4.17 years, and the mean duration of infertility was 4.66±3.79 years. HSG showed normal findings in 58.3% and abnormal findings in 41.7% of patients, with bilateral cornual block being the most frequent abnormality. FTR was performed in 8 patients, with successful tubal patency achieved in 5 (62.5%) and conception in 3 (37.5%). There was no significant association between HSG findings and conception rate (p>0.05).

Conclusions: HSG is a simple, reliable, and cost-effective method for initial evaluation of tubal patency. FTR is a safe and effective therapeutic procedure for managing proximal tubal obstruction, improving fertility outcomes, and reducing the need for more invasive interventions.

Elective induction of labour at 39 weeks in low-risk nulliparous women versus expectant management: a pilot randomized control trial

Aakanksha, Archana Kumari, Sarita Tirkey — Thu, 29 Jan 2026 00:00:00 +0530

Background: Elective induction of labor (EIOL) is a debated topic, but recent evidence suggests potential benefits. The ARRIVE trial found that e IOL at 390/7 to 394/7 weeks in low-risk nulliparous women significantly reduced cesarean delivery rates (18.6% vs. 22.2%) and composite perinatal morbidity (4.3% vs. 5.4%).³ This aligns with other studies showing that continuing pregnancy beyond 39 weeks increases maternal/fetal risks. Given that race/ethnicity influences pregnancy duration and outcomes, the current research gap is the lack of specific data on e IOL at 39 weeks in the Indian population

Methods: This open-label randomized trial at RIMS, Ranchi (March 2021-October 2022) compared EIOL to Expectant Management (EM) in 60 low-risk nulliparous Indian women (n=30 per group), with the primary outcome being the rate of cesarean delivery. Participants were randomized at 38 weeks and the e IOL group was induced between 39 and 395/7 weeks using dinoprostone/oxytocin.

Results: The present randomized, open-label trial conducted on low-risk nulliparous Indian women compared EIOL at 39 weeks with expectant management (EM), analyzing 27 participants in each final group. The primary finding demonstrated that e IOL significantly reduced the Cesarean Delivery rate (37% vs. 66.7% in EM, p=0.038) and led to a shorter postpartum hospital stay. While baseline characteristics were comparable, the EM group developed more complications (e.g., preeclampsia, non-reassuring FHR) leading to higher intervention rates. Although secondary neonatal outcomes (e.g., perinatal death, NICU admission) showed a favorable trend for e IOL, these differences were not statistically significant.

Conclusions: This pilot RCT in India found that EIOL at 39 weeks significantly reduced the cesarean delivery rate (33.3% vs. 60% in expectant management, p=0.038), suggesting one CS is avoided per four inductions. EIOL was safe, showing no increase in adverse maternal outcomes (PPH, infection) and even shorter hospital stays, while maintaining positive neonatal outcomes. The study supports EIOL as a safe, effective strategy to lower CS rates in low-resource settings.

Awareness and practices related to preconception health among women of reproductive age attending a tertiary care hospital in Eastern India

Pritish Dhal, Sriyanka Priyam, Subraham Pany, Mahesh Rath — Fri, 09 Jan 2026 00:00:00 +0530

Background: Preconception health refers to the health status of women during their reproductive years before conception occurs. Optimal preconception health improves maternal and neonatal outcomes and reduces adverse pregnancy outcomes. Objectives were to assess the level of awareness regarding preconception health and to identify factors associated with adequate awareness among women of reproductive age.

Methods: A hospital-based cross-sectional study was conducted among women aged 18-45 years attending outpatient departments of a tertiary care hospital in eastern India from November 2024 to April 2025. Data were collected using a pre-tested structured questionnaire.

Results: Among 220 women studied, 41.8% had adequate awareness regarding preconception health. Higher education, previous antenatal care exposure, and planned pregnancy were significantly associated with adequate awareness.
Conclusions: Awareness regarding preconception health was suboptimal. Strengthening preconception counselling through routine health services is essential.

Prevalence of various types of congenital malformations: a hospital based descriptive cross-sectional study

Lalita Solanki, Radha Rastogi, Ekta Basera — Mon, 19 Jan 2026 00:00:00 +0530

Background: World Health Organization (WHO) defines birth defect as structural or functional anomalies during intrauterine life which are identified during prenatal, at birth and sometime later in the infancy^. The international statistical classification of diseases includes birth defects in chapter XVII as congenital malformations, deformations and chromosomal abnormalities.

Methods: This was a descriptive cross sectional observational hospital-based study conducted on prevalence of various types of congenital malformations at Department of Obstetrics and Gynecology, RNT Medical College, Udaipur. Study period from February 2024 to February 2025.

Results: Among the 250 mothers, the majority were primigravida (G-1) at 39.6%, followed by G-2 at 27.9%, G-3 at 20.1%, G-4 at 8.5%, and multigravida beyond four pregnancies (>G-4) at 4%. 211 mothers (86.2%) had no previous history of abortion, while 39 (13.8%) reported prior abortions. Among these, 19 cases (7.6%) were induced and 20 cases (8%) were spontaneous, indicating a slightly higher prevalence of spontaneous abortions. majority of congenital anomalies were seen in mothers aged 20-30 years (58.8%), with central nervous system (CNS) defects being the most common across all age groups.

Conclusions: This study highlights that congenital malformations, CNS defects were the leading anomalies, followed by cardiovascular and genito-urinary (GU) malformations. Most cases occurred among mothers aged 20-30 years, and first and second pregnancy, with a higher prevalence in rural populations.

Diagnostic accuracy of the triglyceride-glucose index for gestational diabetes screening: evidence from an Indian cohort

Tanya Singhal, Reena Yadav, Ritu Singh — Thu, 29 Jan 2026 00:00:00 +0530

Background: Gestational diabetes mellitus (GDM) is associated with significant maternal and fetal complications, yet current screening methods such as the oral glucose tolerance test (OGTT) remain cumbersome, costly and inconvenient. The triglyceride-glucose (TyG) Index is an emerging surrogate marker of insulin resistance and may offer a simpler alternative for GDM screening. To evaluate the diagnostic accuracy of the TyG Index for screening GDM at 24–28 weeks of gestation in an Indian population.

Methods: This cross-sectional study included 270 pregnant women (19–40 years) attending antenatal care at Lady Hardinge Medical College, New Delhi (January 2021–August 2022). Women with pre-existing diabetes, hypertension, liver disease or medications affecting glucose or triglycerides were excluded. All participants underwent fasting OGTT using IADPSG criteria and simultaneous fasting triglyceride measurement. The TyG Index was calculated as: TyG=Ln (fasting triglycerides (mg/dl) ×fasting plasma glucose (mg/dl))/2. ROC analysis was conducted to determine the optimal cut off and diagnostic performance metrics were computed.

Results: The TyG Index demonstrated a strong discriminative ability with an AUC of 0.874 (95% CI: 0.829–0.912). A cut off value of 4.9 yielded a sensitivity of 82.72%, specificity of 78.31%, PPV of 62.04%, NPV of 91.36% and overall accuracy of 79.63%. Using this threshold, GDM prevalence was overestimated (40%) compared to OGTT-based prevalence (30%). Women with TyG>4.9 had significantly higher Fasting, 1-hour and 2-hour glucose levels (p<0.001) and higher systolic blood pressure (p<0.05).

Conclusions: The TyG Index demonstrates good diagnostic accuracy and high sensitivity for detecting GDM, suggesting its potential as a simple, single-step screening tool that may reduce the need for OGTTs. However, it overestimates GDM prevalence and larger multicentric studies are required before widespread implementation in India.

Impact of vaginal delivery on pelvic floor musculature in terms of clinical and elastographic changes

Shubhra Agarwal, Maryada Jain, Akshata Jaykumar Chordiya — Thu, 29 Jan 2026 00:00:00 +0530

Background: Vaginal delivery imposes considerable strain on pelvic floor musculature, often resulting in structural and functional changes that may contribute to postpartum pelvic floor dysfunction (PFD). This study aimed to assess clinical and elastographic changes in pelvic muscle tone following vaginal delivery. To evaluate the recovery of pelvic floor muscle tone through clinical grading and shear wave elastography (SWE) in primigravida women post vaginal delivery and to correlate both assessment modalities.

Methods: A prospective observational study was conducted over 18 months at TMMCRC. Primigravida women with vaginal deliveries were enrolled. Clinical tone (Oxford scale) and elastographic stiffness (kPa) were assessed pre-delivery, 48 hours, 3 months and 6 months postpartum. Data were analyzed using SPSS, with correlations tested with Kappa statistics.

Results: The mean age of participants was 24.4±2.8 years and 64% were overweight (BMI>25 kg/m²). Most had a second stage of labor<60 minutes (92%) and spontaneous vaginal delivery (96%). Pre-delivery clinical grading revealed 86% with Grade 2 tone, while elastography showed 64% with ES4 stiffness. At 6 months postpartum, 76% achieved Grade 4 tone and 60% achieved ES1 elasticity, indicating significant recovery (p<0.01). A strong correlation was observed between clinical and elastographic grading (Kappa=0.76, p=0.007). Persistent symptoms included dyspareunia in 14% and stress urinary incontinence in 8%.

Conclusions: Pelvic floor muscle tone progressively improved post vaginal delivery. SWE and clinical grading are complementary and reliable for tracking postpartum recovery.

Endometrial hysteroscopic and histopathological characteristics in infertile women with polycystic ovary syndrome versus unexplained infertility: a comparative cross-sectional study

Chitra Thyagaraju, Mubhachini Chandrashekaran, Bhawana Badhe, Sadish Kumar — Thu, 29 Jan 2026 00:00:00 +0530

Background: Polycystic ovary syndrome (PCOS) affects 5-15% of reproductive-aged women and accounts for nearly 90–95% of anovulatory infertility. Beyond ovulatory dysfunction, PCOS is associated with insulin resistance, obesity, chronic inflammation, and increased metabolic and atherogenic risk. These factors predispose to endometrial dysfunction, hyperplasia, and carcinoma, contributing to implantation failure and miscarriage. Hence, evaluation of endometrial abnormalities in PCOS is essential for comprehensive infertility management. Aim of the study was to compare hysteroscopy and histopathological endometrial findings in infertile women with PCOS and unexplained infertility (UI), and to correlate clinical and hormonal profiles between the groups.

Methods: A cross-sectional analytical study conducted over two years in a tertiary care obstetrics and gynecology center. A total of 165 infertile women were included (85 with PCOS, 80 with UI). After informed consent, detailed clinical evaluation was performed. Hormonal profile and pelvic ultrasound were done on day 2 of menstruation. Diagnostic laparoscopy, hysteroscopy, laparoscopic ovarian cautery (where indicated), and endometrial biopsy were performed. Clinical, hormonal, hysteroscopic, and histopathological findings were compared between both the groups. Statistical analysis was done using statistical package for the social sciences (SPSS) v26; p<0.05 was considered significant.

Results: Women with PCOS were younger and had significantly higher BMI and longer duration of infertility than UI (p<0.05). Day-2 endometrial thickness was significantly higher in PCOS (7.5±1.8 mm versus 5.6±1.7 mm). Hysteroscopy was normal in 82% of PCOS and 70% of UI women. Micropolyps and hyperemic endometrium were more frequent in PCOS, while polyps, adhesions, and uterine anomalies predominated in UI. Histologically, PCOS showed higher rates of proliferative and disordered proliferative endometrium, with endometrial hyperplasia detected in 8.4%, compared to none in UI.

Conclusions: Normal hysteroscopic findings do not reliably indicate a normal endometrial milieu in PCOS. Routine endometrial biopsy alongside hysteroscopy may uncover subclinical pathology and improve infertility management in this population.

A cross-sectional study for induction to delivery interval with sweeping of membrane followed by misoprostol

Thu, 29 Jan 2026 00:00:00 +0530

Background: Post-term pregnancy carries increased maternal and neonatal risks, necessitating timely and effective induction. Membrane sweeping is a simple mechanical technique that promotes endogenous prostaglandin release and may enhance the cervical-ripening effect of misoprostol. This study evaluated whether membrane sweeping before misoprostol improves induction outcomes in term nulliparous women.

Methods: A cross-sectional study was conducted among 78 low-risk nulliparous women ≥40 weeks. Group 1 (n=39) received misoprostol alone, and group 2 (n=39) underwent membrane sweeping followed by misoprostol. Primary outcome was the induction-to-delivery interval; secondary outcomes included latency period, induction-to-full dilatation, labor duration, oxytocin requirement, maternal complications, and neonatal outcomes. Standard statistical tests and logistic regression were applied using IBM SPSS v1.0.0.1406.

Results: Baseline characteristics were comparable (mean age 26.47 years, BMI 23.38 kg/m², gestational age 40.32 weeks, Bishop score 4.37). Membrane sweeping significantly shortened duration of labor and time to full dilatation (p<0.05). The mean induction-to-delivery interval was 18.01 hours, with a faster trend in the sweeping group. Latency period strongly correlated with full dilatation (r=0.853) and induction-to-delivery interval (r=0.876) (p<0.001). Maternal and neonatal complications were similar. Mean APGAR scores were 6.87 at 1 minute and 8.88 at 5 minutes; mean birth weight 3.11 kg.

Conclusions: Membrane sweeping before misoprostol is a safe and effective adjunct that improves labor progression without increasing maternal or neonatal risks.

Comparing the fetal and maternal outcomes of dual endocrinopathy with that of isolated gestational diabetes mellitus and hypothyroidism in Indian pregnant women

Pranav Pothanis, Srinivas K. Jois, Vishnu Jayarajan — Thu, 29 Jan 2026 00:00:00 +0530

Background: Both diabetes mellitus and hypothyroidism are known to cause adverse effects for mother and fetus, however, their combined effect has not been adequately studied in the Indian context. This study aimed to fill that gap.

Methods: A prospective cohort study was conducted with three groups. Group 1 consisted of mothers diagnosed with gestational diabetes mellitus only (n=61), group 2 consisted of hypothyroidism only (n=55) and group 3 consisted of pregnant patients diagnosed with both gestational diabetes mellitus and hypothyroidism (n=35). These three groups were followed up from the time of diagnosis, for up to one week following delivery. The maternal outcomes assessed include premature rupture of membranes, preterm labour and preeclampsia. Fetal outcomes include APGAR scores at 1 minute and 5 minutes, NICU admission and birth weight.

Results: Amongst the three groups, mothers with gestational diabetes mellitus had the highest birth weights of babies (2.99±0.61 kg), followed by dual endocrinopathy group (2.44±0.76 kg) , and lastly, by hypothyroidism group (2.22±0.71 kg). Other outcomes did not have any significant association with type of endocrinopathy.

Conclusions: Pregnant patients diagnosed with hypothyroidism alone have chances of having babies who are small for gestational age whereas the other two groups are likely to have large for gestational age babies. Further studies are required to confirm this finding.

Association of ovarian response with anogenital distance in patients undergoing ovarian stimulation for in vitro fertilization/intra cytoplasmic sperm injection: a prospective cohort study

Kandapu Mounika, Renu Tanwar, Anjali Tempe — Thu, 29 Jan 2026 00:00:00 +0530

Background: The study investigates whether Anogenital Distance (AGD), a permanent marker of the prenatal hormonal environment, is associated with established ovarian reserve markers (FSH, AMH, AFC). Crucially, the aim is to determine if AGD can predict Ovarian Sensitivity Index (OSI) and overall ovarian response during controlled ovarian stimulation (COS) for IVF/ICSI.

Methods: This was a prospective cohort study conducted at an Indian IVF Reproductive and Biology Centre, located within the Department of Obstetrics and Gynaecology at Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi (n=40), aiming to evaluate the association of the anogenital distance (AGD), measured using digital calipers, with ovarian response, specifically the ovarian sensitivity index (OSI), and clinical outcomes in infertile women undergoing their first IVF/ICSI cycle.

Results: The study confirmed that age and AFC are inverse determinants of ovarian response, with low responders being older, having lower AFC, and requiring the highest gonadotropin dose. This resulted in highly significant differences (p<0.001) in oocyte yield, embryo formation, and ovarian sensitivity index (OSI), which peaked sharply in high responders (9.50\pm 2.87). Consequently, the clinical strategy varied significantly: Fresh ET dominated in Low/Normo groups, while 83.3% of high responders underwent frozen ET. Critically, the clinical pregnancy rate was highest in Normo Responders (42.8%), showing a statistically significant difference (P=0.03), while anogenital distance (AGD) showed no significant difference across the groups.

Conclusions: This study confirmed that age and poor ovarian reserve (high FSH, low AFC, low OSI) significantly define low responders, leading to inferior IVF cycle productivity compared to normo and high responders. Although anogenital distance (AGD) itself wasn't significantly different between groups, it positively correlated with key ovarian markers (AFC, OSI), suggesting it is a promising but unproven biomarker for ovarian reserve.

Diagnostic efficacy of endometrial aspiration cytology in women with abnormal uterine bleeding and its correlation with histopathology

Aparna, Veena Gupta, Sadhana Pandey, Kachnar Verma — Thu, 29 Jan 2026 00:00:00 +0530

Background: Abnormal uterine bleeding (AUB) is a frequent gynecological concern and a major contributor to hysterectomies. Endometrial aspiration cytology (EAC) offers a minimally invasive alternative to dilatation and curettage (D and C) for diagnosing endometrial pathologies. Objective was to assess the diagnostic efficacy of EAC in detecting underlying causes of AUB and correlate its findings with histopathological examination (HPE).

Methods: A prospective analytical study involving 127 women with AUB was conducted. EAC was performed using an infant nasogastric tube, followed by D and C or hysterectomy. The cytological and histological findings were compared.

Results: The mean age was 41.57±8.42 years. Heavy menstrual bleeding was the most common pattern. EAC demonstrated a sensitivity of 66.67%, specificity of 100%, PPV of 100%, and NPV of 99.07% for diagnosing malignancy. Significant cyto-histological correlation was observed (p<0.001).

Conclusions: EAC is a safe, cost-effective, outpatient procedure with high specificity for detecting endometrial malignancy. It is especially useful in resource-limited settings as a first-line diagnostic tool.

Clomiphene citrate versus letrozole with gonadotropins in intrauterine insemination cycle

Nikita Jindal, Shakun Singh, Rachna Chaudhary — Thu, 29 Jan 2026 00:00:00 +0530

Background: This study aimed to evaluate and compare the efficacy of clomiphene citrate (CC) and letrozole, both alone and in combination with gonadotropins, for ovulation induction in infertile women.

Methods: A total of 200 participants were divided into four groups: CC alone, letrozole alone, CC plus gonadotropins, and letrozole plus gonadotropins. Ovulation was monitored via transvaginal ultrasonography, with human chorionic gonadotropin (HCG) administered to trigger ovulation when follicles reached ≥18 mm. Intrauterine insemination (IUI) was performed 24-36 hours post-HCG administration.

Results: The letrozole plus gonadotropins group exhibited the highest ovulation rate (86%), followed by CC plus gonadotropins (84%), letrozole alone (72%), and CC alone (70%). Endometrial thickness was significantly greater in the letrozole group (8.53±1.40 mm) compared to the CC group (7.47±0.89 mm; p=0.000), and the size of the dominant follicle was also larger with letrozole (19.20±4.87 mm) than with CC (17.54±5.44 mm; p=0.02).

Conclusions: Letrozole, particularly when combined with gonadotropins, may be more effective than CC in inducing ovulation and enhancing endometrial receptivity, thereby potentially improving pregnancy outcomes in infertile women.

Maternal and fetal outcomes with increasing maternal age during pregnancy: a hospital-based study

Anjana Mavelil, Neetha Nandan — Thu, 29 Jan 2026 00:00:00 +0530

Background: In recent decades, delayed childbearing has become increasingly common due to socio-economic and professional factors, leading to a rise in pregnancies among women aged 30 years and above which may have an impact on obstetric and perinatal outcomes. Aim was to evaluate the association between increasing maternal age and adverse maternal and neonatal outcomes in singleton pregnancies beyond 30 years of age.

Methods: Total of 207 pregnant women aged >30 years were recruited and categorised into three age groups: 30-34 years, 35-40 years (AMA- advanced maternal age) and >40 years (VAMA- very advanced maternal age). Maternal and neonatal parameters were noted.

Results: The incidence of fibroid complicating pregnancy, thyroid disorders in pregnancy significantly increased with increase in maternal age. The risk of gestational diabetes, gestational hypertension was more with increase in age (AMA, VAMA group) but preeclampsia was noted more in age group of 30-34 years. Preterm delivery and induction of labour was more in 30-34 years of age. The rate of caesarean section showed a steady increase after 35 years of age. Postpartum hemorrhage was two times more and gestational hypertension was 5 to 7 times higher in AMA and VAMA groups compared to 30-34 years age group.

Conclusions: There was increase in fibroid complicating pregnancy and thyroid disorders in pregnancy in women >35 years of age. The association of GDM, gestational hypertension, the need for caesarean section was also high with increase in maternal age >35 years of age. In 30-34 years of age group preeclampsia, preterm delivery and induction of labour was found to be higher.

Prevalence of postpartum depression in a tertiary care centre

Abinaya Radhakrishnan — Thu, 29 Jan 2026 00:00:00 +0530

Background: Postpartum depression (PPD) is characterized as a depressed episode that transpires during pregnancy or within four weeks following childbirth. Diagnosing postpartum depression is essential, since it can hinder normal maternal-infant attachment and adversely affect both the short-term and long-term development of children. Hence this study was conducted to determine the prevalence of postpartum depression in a tertiary care centre.

Methods: A prospective observational study was performed at a tertiary health care center for a period of 6 months. A total of 150 post-natal mothers were included in this study. After getting informed written consent, post-natal mothers were evaluated with the Edinburgh Postnatal Depression Scale (EPDS) at 24-48 hours and at 4 weeks postpartum. The threshold score for identifying severe depression is 13 or higher. All the data’s recorded are entered in Microsoft Excel and analysed using SPSS version 21.0.

Results: The study comprised 150 women, of which 24 exhibited postpartum depression. The prevalence of postpartum depression in this study cohort is 16%. It was found that socio-demographic characteristics such as age and occupation together with social variables like pressure to have a male child, and obstetric factors including age at marriage and mode of delivery, were significant predictors of postpartum depression.

Conclusions: This study observed a 16% prevalence of postpartum depression among postnatal mothers. With the increasing trend in the prevalence of depression, it is essential to incorporate screening for postpartum depression in all women.

Retained and forgotten intrauterine contraceptive devices: a case series from Kasturba Hospital, Delhi

Maruti Sinha, Rekha Rani, Kavita Gupta, Aditi Gaur — Tue, 13 Jan 2026 00:00:00 +0530

Intrauterine contraceptive devices (IUCDs) are widely used for long-acting reversible contraception. Rarely, devices may be retained, forgotten, or only discovered incidentally years later, presenting diagnostic and management challenges. We report four women who presented to the outpatient department of Kasturba Hospital, Delhi with retained or missing IUCDs. Presentations ranged from symptomatic postmenopausal bleeding and pelvic pain to incidental discovery in surgical specimens. Imaging and removal strategies varied according to clinical scenario. These cases underscore the importance of thorough history, targeted imaging, documentation of IUCD insertion, and patient education to prevent prolonged unnoticed retention. They highlight diagnostic pitfalls and management dilemmas in both symptomatic and asymptomatic retained devices.

Antenatal myomectomy: when to intervene and why?

Thu, 29 Jan 2026 00:00:00 +0530

Uterine myomas affect 2-10% of pregnant women. In every one out of ten patients, myomas complicate the course leading to adverse pregnancy outcomes such as placental abruption, premature rupture of membranes, placenta previa, preterm labor, fetal malpresentation, Myomectomy is rarely performed during pregnancy because of fear of miscarriage and the risk of uncontrolled hemorrhage. Surgical management is needed in selected cases where conservative management fails to manage symptoms and there is a substantial risk of adverse pregnancy outcomes. This article provides insight into the safety, risks and benefits of antenatal myomectomy. This is a retrospective analysis of 6 patients who underwent myomectomy between 16-19 weeks of gestation at our tertiary care centre. Decision for surgical management was based on large fibroid size and refractory pain. Myoma was enucleated via transverse incision and reconstruction of uterine wall was done in double layer. None of the patients in our study had miscarriage, preterm labour, premature rupture of membranes, placental abruption. All patients delivered at term with median gestational age of 37 weeks, 5 by elective caesarean section and one patient delivered vaginally after induction of labour. None of the patients delivered a growth-restricted fetus or a fetus with a congenital anomaly. No adverse maternal or fetal outcome was reported. Antenatal myomectomy should not be done as a routine procedure. However, in carefully selected patients in skilled hands it is a safe procedure and gives good pregnancy outcomes while avoiding the complications typically linked to the presence of myomas.

Rare presentation of scar endometriosis in atypical and typical locations: a case series

Maruti Sinha, Rekha Rani, Kavita Gupta, Hitesha Sharma — Thu, 29 Jan 2026 00:00:00 +0530

Scar endometriosis is an uncommon but well-documented entity resulting from the iatrogenic implantation of endometrial tissue into surgical scars. It is most frequently seen following caesarean section or other obstetric and gynaecological procedures and is often misdiagnosed due to its rarity and variable presentation. This case series presents patients with scar endometriosis involving both classical and unusual sites, highlighting diagnostic challenges and management outcomes. Patients with clinically and histopathologically confirmed scar endometriosis managed at Kasturba Hospital, Delhi over a two-year period were evaluated with respect to presenting symptoms, site of involvement, surgical history, diagnostic work-up, treatment, and follow-up. All patients presented with cyclical pain and swelling at or near surgical scars, with some demonstrating uncommon locations such as the episiotomy scar, umbilicus, and lateral abdominal wall. Surgical excision of the lesions with clear margins resulted in complete symptom relief in all cases. Histopathological examination confirmed the presence of endometrial glands and stroma in all excised specimens. No recurrence was observed during the follow-up period. Scar endometriosis should be suspected in women presenting with cyclical pain and swelling at or near surgical scars, particularly following obstetric or gynaecological procedures. Awareness of atypical presentations facilitates early diagnosis and effective surgical management.

Eisenmenger syndrome in pregnancy: experience from a tertiary care centre

Nidhi Chaturvedi, Hetal More — Thu, 29 Jan 2026 00:00:00 +0530

Eisenmenger syndrome first described by Victor Eissenmenger is the end stage of a long-standing congenital left -right shunt, characterised by reversal of shunt, pulmonary hypertension and heart failure. Pregnancy with its haemodynamic changes, in these women is contraindicated due to high risk of poor maternal and foetal outcome, as stated by WHO and is considered for termination. However, if pregnancy is continued, management requires intense monitoring and multidisciplinary approach in a resource intense centre. Present article describes the clinical presentation, management and outcome of three pregnant women with Eisenmenger syndrome in a tertiary care centre in Rajasthan. All three women presented in late pregnancy for the first time. Two had a known congenital defect but were non-compliant with their treatment and follow up. They were unaware of the risks of pregnancy in their condition. One woman was diagnosed for the first time in pregnancy. All women delivered by emergency Caesarean Delivery due to complications. However maternal and foetal outcome was good in all three women and they were discharged in stable condition. Counselling regarding the need for regular follow up and avoidance of pregnancy was done at the time of discharge. Eisenmenger syndrome poses a significant challenge in pregnancy with high risk of complications to both mother and foetus. Favourable outcome may be achieved with advanced cardio- obstetric team in a well-equipped centre. However, counselling regarding avoidance of pregnancy or regular antenatal care must be impressed upon in young women with congenital heart defects.

Innovation in nursing led maternal and infant care: emerging trends and impact in Indian clinical setting

Thu, 29 Jan 2026 00:00:00 +0530

Nursing-led models of maternal and infant care are increasingly recognised as pivotal strategies for improving survival, quality of care, and patient experience in India’s evolving health system. Despite substantial gains in institutional delivery and service coverage, preventable maternal and neonatal deaths persist, largely due to gaps in quality, continuity and respectful care. This systematic review synthesises evidence on nursing- and midwifery-led innovations across community, facility, digital and quality-improvement domains in Indian clinical settings. Evidence indicates that community-based interventions such as home-based newborn care (HBNC), delivered through trained and supervised nursing cadres, significantly reduce neonatal mortality and improve early breastfeeding and care-seeking behaviours. Facility-based midwifery-led care, including midwifery-led care units (MLCUs), demonstrates lower intervention rates, enhanced maternal autonomy and high satisfaction without compromising neonatal outcomes among low-risk women. In neonatal intensive care units (NICUs), nurse-led developmental supportive care, Kangaroo mother care (KMC), breastfeeding counselling and maternal participation interventions improve neurobehavioural outcomes, thermoregulation, bonding and maternal mental wellbeing. Digital health innovations implemented by nurses, auxiliary nurse midwives (ANMs) and accredited social health activists (ASHAs) enhance health communication, tracking and service utilisation, while quality-improvement initiatives such as LaQshya strengthen intrapartum safety, teamwork and adherence to evidence-based practices. Key enablers include competency-based education, regulatory recognition of advanced nursing roles, supportive supervision, adequate staffing and integrated digital systems. Persistent fragmentation across the continuum of care remains a challenge, underscoring the need for integrated pathways linking community, labour room, postnatal and neonatal services.