International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Editor in Chief: Dr. Bhaven Kataria

Print ISSN: 2320-1770 (Print)

Frequency: 4 issues a year

Language: English

Open Access Peer-reviewed journal

Web site: https://www.ijrcog.org/index.php/

Browse

Recent Submissions

Now showing 1 - 20 of 1790
  • Item
    Study of umbilical coiling index and perinatal outcome
    (Medip Academy, 2020-10) Singh, Sujata; Pai, Swati; Sahu, Barsha
    Background: Study was to evaluate the relationship between umbilical coiling index (UCI) and hypo-and hyper coiling of the umbilical cord and parity, neonatal weight, Ponderal Index (PI), APGAR (Appearance, pulse, grimace, activity, and respiration) score, meconium staining of the amniotic fluid, Intrauterine growth restriction (IUGR), hypertensive disorders of pregnancy and delivery interventions.Method: A prospective analytical study was performed from January 2017 to December 2018. Total of 300 patients giving birth at labour room of SCB Medical College, Cuttack were taken into study. Immediately following delivery, the umbilical cord was clamped at the foetal end and cut with scissors. UCI, mode of delivery and perinatal outcome was followed up.Results: There were 149 lower segment caesarean sections accounting to 49.7% and 151 vaginal deliveries including instrumental deliveries which was accounting to 50.3%. Minimum number of coils observed was 2. The maximum number of coils observed was 50. Caesarean section was more in hypo coiling group. APGAR score at 5 min was calculated and there was a total of 109 neonates who had APGAR <7 at 5 minutes (36.33%) out of which there were 17 neonates with hypo coiling (2.33%), 77 neonates with normo-coiling (25.66%) and 15 neonates with hyper coiling (5%). Meconium staining and instrumental delivery was more associated with hyper coiling.Conclusion: Both hyper-coiling and hypo-coiling had significant correlation with adverse perinatal outcome. If the UCI can be measured reliably in utero by ultrasound, then it might be a promising prognostic marker for adverse pregnancy outcome.
  • Item
    Obesity and women health: from womb to tomb
    (Medip Academy, 2020-10) Garg, Shivani; Grover, Seema; Garg, Nishi
    Obesity is a highly prevalent disease reaching epidemic proportions these days in India. Obesity affects all human beings especially women affecting their health drastically. It affects each phase of their life in serious manner. We present here the spectrum of diseases that obesity can cause to a women during her entire life.
  • Item
    A comparative study of oral versus intravenous iron in the treatment of moderately anaemic pregnant women
    (Medip Academy, 2020-10) Gupta, Shivika; Gupta, Ranjana
    Background: Anemia, the decrease of haemoglobin (Hb) concentration is a common disorder complicating pregnancy mostly due to hemodilution, increased demand of iron and poor dietary intake of iron. The aim of this study was to evaluate whether parenteral iron sucrose can be used as an alternative to daily oral iron during pregnancy.Methods: It was a prospective interventional study conducted in the Department of Obstetrics and Gynaecology, Rohilkhand Medical College and Hospital, Bareilly involving pregnant women at 16-24 weeks with Hb 7-10 g/dl. They were randomly allocated to two groups I and II. Group I (oral group) was given oral iron tablets containing 100 mg of elemental iron and 0.5 mg of folic acid as per therapeutic requirement. Group II (parenteral group) were admitted as day care patients and given a total calculated dose of iron sucrose in divided doses of 200 mg each in 100 ml of normal saline as slow intravenous infusion. Hb, packed cell volume (PCV), blood indices were measured at the start, 2 weeks and 4 weeks of treatment. Any side-effects of treatment were also studied.Results: A statistically significant increase in values of Hb, hematocrit, reticulocyte count, red blood cells (RBC's) indices: mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular hemoglobin (MCH) coupled with no serious side effects with iron sucrose as compared with oral iron.Conclusions: Intravenous iron sucrose complex is safe, convenient and effective alternative to oral iron for treatment of iron deficiency anemia in pregnancy.
  • Item
    Understanding pelvic floor in women
    (Medip Academy, 2020-10) Mittal, Rajni; Rath, Gayatri; Sahai, R. N.; Aggarwal, Mahima
    Change from quadruped to erect posture has resulted in changes in the human pelvis. This has resulted in pelvis supporting the abdominal viscera. The bony pelvis is deficient on inferior aspect. Muscles covered by fascia on superior and inferior aspect. A good knowledge of pelvic floor is very basic and mandatory for any gynecologist as pelvic floor is crucial to support the pelvic organs and is required to maintain urinary and fecal continence.
  • Item
    Xanthogranulomatous salpingo-oophoritis: a case report and review of literature
    (Medip Academy, 2020-10) Patel, Keval A.; Chothani, Kinalee P.; Patel, Bimal; Lanjewar, Dhaneshwar N.
    Xanthogranulomatous inflammation of ovary is a rare disease that is characterized by presence of large number of lipid laden macrophages with an admixture of neutrophils, lymphocytes, plasma cells and multinucleated giant cells. It is misdiagnosed as ovarian tumour that leads to extensive surgery including hysterectomy. In this report we describe a case of Xanthogranulomatous salpingo-oophoritis along with review of literature.
  • Item
    Laparoscopic intra-ovarian platelet rich plasma injection for ovarian rejuvenation: a new hope for infertile women
    (Medip Academy, 2020-10) El Sherbeny, Mohamed Farag
    This case report was presented to show the outcome of bilateral laparoscopic platelet rich plasma intra-ovarian injection for 34-year old woman who had primary infertility secondary to premature ovarian insufficiency and had two previously failed attempts of ICSI. One month after the procedure, the patient had menses and her hormonal profile was improved with increased serum AMH and E2 and decreased serum FSH and LH. On the eleventh day of the menstrual cycle, folliculometry detected good follicle measuring 18×20 mm, on the fifteenth day, trans-vaginal ultrasonography assured ovulation and timed intercourse was ordered, and she got pregnant. At the thirty fifth gestational week, she had premature preterm rupture of membrane and urgent cesarean delivery was performed and the newborn was admitted to neonatal intensive care unit. As conclusion, intra-ovarian PRP injections could be safe, productive, and a natural treatment for women with POI. Laparoscopic injection allowed perfect under-vision intra-ovarian injection and can be conducted as one-day procedure and this can be considered a novelty of the applied procedure.
  • Item
    A case report of primary ovarian leiomyoma
    (Medip Academy, 2020-10) Doddareddy, Srikala; Undinti, Nagashree; G., Vishnu Vandana
    Primary ovarian Leimyoma is a rare benign mesenchymal tumour usually arising from smooth muscle of walls of ovarian blood vessels. It’s mostly discovered incidentally. Here we report a case in which a 24-year-old unmarried woman presented with pain and discomfort in lower abdomen since 10 days. On further evaluation through imaging and blood works, we proceeded with surgical management. Immunohistochemistry confirmed the final diagnosis of ovarian leiomyoma. However, it’s important to keep this entity as a differential diagnosis for solid ovarian tumors.
  • Item
    Previous two lower segment caesarean section with placenta previa and placenta accreta woman with COVID-19 suspect: case report
    (Medip Academy, 2020-10) Borse, Dhananajay; Mitra, Binay; Sharma, Aparna
    A pregnant woman with gravida 3, para 2, living 2 and gestational age of 37 weeks and 3 days was referred to a zonal hospital as previous two lower segment caesarean section (LSCS) term pregnancy with placenta previa for safe confinement with complaints of dry cough. She was admitted with a diagnosis of COVID-19 suspect. During her hospitalization, oxygen (O2) saturation was normal. On investigations her counts were normal. Patient was planned for elective LSCS. COVID-19 test i.e. real time-polymerase chain reaction (RTPCR) report was suspect and asked for repeat sampling. During elective LSCS, delivered single live female baby with intra operative findings of placenta previa with adherent placenta and permpartum hysterectomy was done for same. Uterus with placenta was sent for histopathological examination (HPE). During the surgery her oxygen concentration was normal. Her postoperative recovery was uneventful.
  • Item
    A study on obstetric patients with corona virus infection requiring critical care
    (Medip Academy, 2020-10) Preet, Adarsh; Palve, Tushar
    Background: Coronavirus cause respiratory tract infection that can range from mild to lethal like cold, fever, cough, shortness of breath, fatigue, chills, body aches, headache, sore throat, loss of smell or taste, nausea, diarrhoea, pneumonia, respiratory failure, septic shock and death. The purpose of this study was to describe the clinical manifestations of obstetric patients with COVID-19 infection requiring critical care, their 02 requirements, complications, co-morbidities associated and mortality related to it.Methods: A study was conducted in the Department of Obstetrics and Gynecology, Cama and Albless hospital, Mumbai including 31 patients with SARS CoV-2 infection requiring critical care. Necessary information such as their detailed clinical, and obstetric history, clinical examination, investigations was noted.Results: In our study, the most common symptoms were shortness of breath, followed by fever. PIH was the most common co morbidity associated and pneumonia as most common complication. Anemia, thrombocytopenia and NLR>4 were found more common in intensive care unit (ICU) admitted patients as compared to non-ICU admitted patients. 77.4% of patients had abnormal chest X-ray with 25.8% requiring mechanical ventilation.Conclusions: COVID 19 infection is affecting pregnant women resulting in mild to lethal disease. Most of pregnant women are asymptomatic or have mild disease but some of them require critical care. These women should be monitored carefully to prevent maternal morbidity and mortality.
  • Item
    Twin reversed arterial perfusion in twin pregnancy
    (Medip Academy, 2020-10) Devi, L. Thulasi; Verma, Vikas
    An interesting case of twin reversed arterial perfusion “TRAP” from a larger apparently normal pump twin with VACTERL abnormality; to smaller structurally abnormal twin in a monoamniotic monochorionic twin pregnancy resulting in fetal demise with subsequent termination of pregnancy. Defect in early embryogenesis leads to such rare multiple presentations.
  • Item
    A rare association of puerperal ovarian venous thrombosis with pseudomembranous colitis
    (Medip Academy, 2020-10) Kamat, Devika J.; Kavlekar, Namrata P.
    Ovarian venous thrombosis is a rare but serious complication associated with early puerperium. The risk of this complication increases with associated puerperal infection or inflammatory condition. The present case report is of a 36-year-old lady who presented after emergency caesarean with puerperal fever and abdominal pain along with diarrhoea post antibiotic cover. Patient presented with moderate ascites and uterine subinvolution on examination. Contrast enhanced computed tomography (CECT) showed evidence of bowel wall edema due of colitis along with ovarian vein thrombosis. Patients had persistent symptoms despite receiving an empirical course of injectable cephalosporins. Stool culture confirmed growth of Clostridium difficile. Patient developed a rare infection after a course of antibiotic i.e. pseudomembranous colitis caused by Clostridium difficile. Patient then received a course of injectable vancomycin after which colitis subsided. This case increases our vigilance on management of puerperal fever which could get complicated with life-threatening events like deep vein thrombosis.
  • Item
    Vasa previa: a case report
    (Medip Academy, 2020-10) Mohapatra, Ipsita; Samantaray, Subha R.; Sindhuja, V. Naga
    Vasa previa is defined as a condition where fetal vessels traverse the membranes in the lower segment below the presenting part unsupported by placental tissue or umbilical cord. Rupture of the membranes leads to fetal exsanguinations and even neonatal death. The etiology is uncertain, but risk factors include bilobed or succenturiate lobed placenta, velamentous insertion of cord, placenta previa, pregnancies resulting from In vitro fertilization (IVF) and multiple pregnancies. We report here a case of 24 year old woman, G3A2 at 34 weeks of gestation and history of 2 previous spontaneous abortions with vasa previa which was successfully managed. Prenatal sonographic diagnosis has the potential to improve or prevent the poor obstetric and neonatal outcome associated with it.
  • Item
    A rare case of peritoneo-cutaneous fistula after cesarean section
    (Medip Academy, 2020-10) Rana, Anshul; Mohindroo, Neha
    Peritoneo-cutaneous fistula is usually a rare but known entity. Such a case has not been reported after cesarean sections. A 26-year female presented to our clinic in May 2019 with persistent sero-purulent discharge from sinus over abdominal skin. The patient had previously undergone a cesarean section in April 2018 for premature rupture of membranes and non-progress of labour. The surgery and puerperal period were uneventful. The patient presented with document high-grade fever in June 2018. In August 2018, a localized painful swelling was noted by the patient herself over the abdomen, contrast-enhanced computed tomography, which suggested 6.3×3.9×3 cm collection in the right adnexal region and a fistulous tract communicating with abdominal skin. For the same she underwent surgery, wide local excision of the fistulous tract around elliptical skin incision was done. The development of delayed peritoneo-cutaneous fistula has been seen as a complication of difficult cholecystectomy.
  • Item
    Ovarian mass in pregnancy: case series
    (Medip Academy, 2020-10) Manvi, M. R.; Deshpande, Radhika
    Ovarian masses in pregnancy are not uncommon. Ovarian masses during pregnancy should be accurately evaluated to identify the patients who need surgical interventions from those where it can be managed conservatively. Ultrasound and magnetic resonance imaging (MRI) are safe diagnostic tools during pregnancy. The overall incidence of ovarian tumours in pregnancy is 2.4-5.7%. Most masses are functional and asymptomatic and up to 70% resolve spontaneously in the second trimester. Both open surgery and laparoscopy can be performed considering the tumour diameter, gestational age and associated complications. A multidisciplinary approach is necessary in case of high suspicion of malignancy. This study evaluates the clinical features, course in pregnancy, management and pregnancy outcome in patients with ovarian masses diagnosed during pregnancy. This was a retrospective analysis of medical records of 6 patients diagnosed with ovarian mass during pregnancy in the department of Obstetrics and Gynaecology at Kanachur Institute of Medical Sciences, Mangalore from June 2019 to June 2020.
  • Item
    Placenta percreta: a rare presentation of obstetric emergency in second trimester
    (Medip Academy, 2020-10) Chavan, Niranjan; Mirza, Hera; Venkateswaran, Sneha; Changede, Pradnya
    Incidence of adherent placenta is on the rise nowadays due to various reasons. Placenta percreta is seen in 5-7% of cases with adherent placenta, patients with morbidly adherent placenta are at increased risk for major obstetric hemorrhage, usually in the third trimester. Here we present an unusual case of placenta percreta presenting with obstetric emergency after trauma to abdomen in the second trimester. Emergency exploratory laparotomy was done for abruptio placentae with scar dehiscence at 20 weeks period of gestation. Consent for obstetric hysterectomy, if needed, was also taken. Intraoperatively, the placenta was found to be adherent to posterior wall of bladder. Emergency obstetric hysterectomy with bilateral internal iliac ligation with cystoscopy with detrusorrhaphy was done. Patient had an uneventful recovery. Multidisciplinary management with obstetricians, urologists and intensivist is presented hereed.
  • Item
    Efficacy and safety of prostaglandins vs double balloon catheter in inducing labor: a meta-analysis
    (Medip Academy, 2020-10) Chong, Jia S.; Chew, York L.; Fernando, Ayendra; Nalliah, Sivalingam
    Background: To compare the efficacy and safety of double‐balloon catheter with prostaglandin E2 (PGE2) in induction of labor.Methods: We searched electronic sources from Medline, Scopus, PubMed, Science Direct and Cochrane Library Database of Systematic Reviews. Only randomized controlled trials and observational studies comparing the PGE2 agents with double-balloon catheter for cervical ripening and labour induction in women with unfavorable cervix were included in the analysis. The main outcomes included vaginal delivery rate within 24 hours and cesarean delivery rates. We calculated relative risks and mean differences using fixed effects and random‐effects models.Results: Prostaglandin was more favourable for vaginal delivery within 24 hours compared to double balloon catheter, but was not statistically significant (RR 1.17: 95% CI 0.96-1.42 p =0.12). The induction to delivery time yielded a non-significant result that again favors prostaglandin (SMD 0.02 CI:0.18,0.22, p = 0.86). There was no significant difference in the cesarean delivery rates between the two groups (RR 1.02: 95% CI 0.92-1.14, p = 0.68). Uterine hyperstimulation and Neonatal Intensive Care Unit (NICU) admissions were significantly higher with prostaglandin. (RR 0.09: CI 0.04, 0.22 p<0.00001 and RR 0.75 CI: 0.62,0.90 p=003).Conclusions: There is no significant difference in the success of induction of labour between use of PGE2 and double balloon catheter. Uterine hyperstimulation and NICU admissions were significantly higher in Prostaglandin group.
  • Item
    Tissue trauma and inflammatory response following laparoscopic versus abdominal hysterectomy: a prospective randomized clinical trial
    (Medip Academy, 2020-10) Abbas, Ahmed M.; Swidan, Khaled H.; Ali, Ahmed M.; Sweed, Mohamed S.
    Background: Laparoscopic surgery is associated with more favorable clinical outcome than conventional open surgery. This might be related to the magnitude of tissue trauma and tissue stress response. This study compares the intensity of tissue injury by assessing plasma C-reactive protein (CRP), lactic dehydrogenase (LDH), and cancer antigen 125 (CA 125) in patients undergoing laparoscopic hysterectomy compared to abdominal hysterectomy.Methods: This study was conducted at Ain Shams University Maternity Hospital from May 2018 to February 2020. 74 women candidate for hysterectomy were recruited and randomized into two groups: group A included 37 cases who underwent abdominal hysterectomy, and group B included 37 cases that underwent laparoscopic hysterectomy.Results: CRP, LDH and CA125 significantly increased post-operatively in both groups. Postoperative mean serum CRP, LDH and CA125 were significantly higher in the laparotomy group (10.84±2.47, 262.21±76.77, and 13.41±2.6 respectively) compared to laparoscopy group (7.92±2.25, 148.53±43.56, 11.79±2.77 respectively) (p<0.05).Conclusions: Surgery is a significant cause of tissue injury that can be assessed by specific markers. We suggest that laparoscopic surgery causes less tissue damage as assessed by lower postoperative CRP and LDH values, which might account for the earlier recovery and reduced hospital stay in laparoscopic surgery.
  • Item
    Uterine artery Doppler in first trimester in prediction of adverse pregnancy outcome in Dharmapuri district of Tamil Nadu
    (Medip Academy, 2020-10) S., Bindu
    Background: Pregnancies are complicated by hypertensive disorders of about 5-10% and hemorrhage, sepsis, and fetal growth restriction constitute a triad contributing to maternal morbidity and mortality. Hypertensive disorders in pregnancy vary from mildly elevated blood pressure to severe hypertension with multi-organ dysfunction. The study aims to evaluate the first-trimester uterine artery Doppler in the prediction of the development of adverse pregnancy outcomes.Methods: This prospective longitudinal observational was done in Dharmapuri Medical College and Hospital were selected for this study. Totally 150 pregnant women were included in the study. 75 were controls and 75 cases. The study period was from June 2018 to February 2019. Evaluating the optimal definition of abnormal first trimester.Results: Previous obstetric history in the study population. In the study group 3% of bad obstetric history (BOH) present. In the case group, 5% has BOH due to 2 neonatal death and 2 term intrauterine device (IUD), uterine artery Doppler parameters to predict adverse pregnancy outcomes, and association of gestational hypertension in the study groups. In the control group, 1%, and the case group 5% of them had gestational hypertension. Out of 4, 3 had an average uterine artery Doppler more than 2.3 (maximum of 2.7) and 1 had single uterine artery Doppler abnormality.Conclusions: The study showed that first-trimester uterine artery Doppler with single and average uterine artery pulsatility index (PI) >95th centile (2.3) has a better screening value in my population. The overall performance of the first-trimester uterine artery Doppler in the prediction of adverse pregnancy outcomes is valuable.
  • Item
    Body mass index and gestational weight gain in pregnant women with gestational diabetes and its relation with adverse maternal and fetal outcome
    (Medip Academy, 2020-10) Singh, Abha; Kujur, Avinashi; Roy, Archana
    Background: Raised body mass index (BMI) and excessive gestational weight gain (GWG) are important determinants in development of gestational diabetes.Methods: A prospective, observational study carried out on antenatal women since their first trimester. These women were screened for gestational diabetes mellitus (GDM) by diabetes in pregnancy study group of India (DIPSI) criteria. All participants were followed up by measuring their BMI, weight gain, blood sugars in every trimester. Also, data was collected regarding any adverse outcomes.Results: Among all participants, 16.8% were diagnosed as GDM. 44% women of study group had weight gain beyond Institute of Medicine (IOM) recommendations. Higher risk of GDM was observed in women with raised BMI and excessive GWG. Also, odds of preeclampsia, preterm deliveries, caesarean section, macrosomia, intrauterine fetal death, neonatal intensive care unit (NICU) admissions were higher in women with GDM.Conclusions: Compliance of recommended weight gain during pregnancy have a strong impact on the fetal outcome. Amount and timing of weight gain plays a crucial role in GDM.
  • Item
    Study of maternal and fetal outcome in pregnancy beyond 40 weeks: a prospective observational study at a tertiary institute
    (Medip Academy, 2020-10) Kori, Shreedevi; Biradar, Dayanand; Biradar, Aruna; Yaliwal, Rajasri; Mudanur, Subhashchandra R.; Patil, Neelamma; Pujeri, Shivakumar
    Background: Prolonged pregnancy is one that exceeds 42 0/7weeks. Management of prolonged pregnancy is very challenging in modern obstetrics.Methods: It is prospective observational study in department of Obstetrics and Gynecology, Shri B.M Patil medical college and Research center, deemed to be University, Vijayapur, North karnataka. Study period was from January 2018 to January 2019.Results: Total of 186 pregnant women were included in the study. Results in terms of age, gravidity, gestational age, time of induction, mode of delivery, neonatal outcome and maternal complications.Conclusion: Pregnancies beyond 40 weeks require early detection, effective fetal monitoring and proper planning of labour. In pregnancies beyond 40 weeks, decision of induction should be taken cautiously as early induction leads to failure of induction and increased rates of lower (uterine) segment Caesarean section (LSCS), while delayed induction leads to increased fetal complications.