International Journal of Clinical Obstetrics and Gynaecology

Journal Information
ISSN / EISSN : 2522-6614 / 2522-6622
Published by: Comprehensive Publications (10.33545)
Total articles ≅ 977
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Afrah Mukadam, Spenta Sumondy
International Journal of Clinical Obstetrics and Gynaecology, Volume 6, pp 05-07; https://doi.org/10.33545/gynae.2022.v6.i2a.1152

Abstract:
27 year old female P1L1 post Lower Segment Cesarean Section who presented with complaints of breathlessness 3-4 hours post her emergency LSCS which had settled with Oxygen via nasal cannula. Patient was asymptomatic on room air after which she was discharged on day 3 of LSCS. Patient presented in the emergency department of our hospital on day 4 post LSCS with complaints of breathlessness at rest since 6 hours. Patient was immediately admitted, evaluated and diagnosed as a case of Peripartum Cardiomyopathy. She was stabilized and managed conservatively.
C Rekha, V Meera Rajagopal, C Divya Yadav, Kalpana Betha
International Journal of Clinical Obstetrics and Gynaecology, Volume 6, pp 01-04; https://doi.org/10.33545/gynae.2022.v6.i2a.1151

Abstract:
Introduction: Induction of labour is mainly attempted when continuation of pregnancy may harm either mother or foetus or both. Different methods of labour induction in full term pregnancy are widely practiced to prevent these complications. There are not enough studies on comparision of mifepristone and misoprostol for induction of labour in full term pregnancy. The present study compared the effectiveness and safety of induction of labour with mifepristone and with misoprostol.Methods: A hospital based, comparative study on hundred pregnant women admitted with term gestation at Mediciti Institute of Medical Sciences, Ghanpur was carried out from April 2018 to September 2019. Women were divided alternatively into 2 groups with 50 in each group (group 1 mifepristone 200 mg was given & in group 2 misoprostol was given). The primary outcome measures were successful vaginal delivery, induction to delivery interval (first dose of misoprostol / mifepristone to complete delivery of fetus and placenta) and secondary outcome measures were failed induction, mode of delivery, birth weight, meconium stained liquor, fetal distress, NICU admission, primary postpartum haemorrhage.Results: The mean age of women in group 1 and group 2 was 23 years and 27.8 years respectively. The mean BMI in both the groups was similar (22.63kg/m2 and 22.27kg/m2). The mean induction to delivery was 31.34hours in group 1 and in group 2, it was 15.79 hours. This was statistically significant in both groups with favourable and unfavourable cervix (p= 0.00001).Conclusion: Women induced with misoprostol had higher rates of successful vaginal delivery, shorter induction to delivery interval and better neonatal outcomes when compared to mifepristone.
Bambara Moussa, Ouedraogo Issa, Kombogo Evelyne, Keita Lassina
International Journal of Clinical Obstetrics and Gynaecology, Volume 6, pp 08-13; https://doi.org/10.33545/gynae.2022.v6.i2a.1154

Abstract:
Objective: Conduct a study on the maternal and neonatal prognosis of twin deliveries within the Gynecology and Obstetrics Department of Sourô Sanou Teaching Hospital of Bobo-Dioulasso. Methodology: This was a descriptive and cross-sectional study on 173 twin deliveries within the Gynecology and Obstetrics Department of Sourô Sanou Teaching Hospital of Bobo-Dioulasso (CHUSS) from January 1st to December 31st, 2019 i.e., a 12-month period. Any parturient with a twin pregnancy having ≥ 28 weeks of amenorrhea, admitted and treated within the department for delivery was included in this study; female patients received for second the twin retention were also taken into account. The parameters studied were the following: 0sociodemographic characteristics, clinical examination and twin delivery data, maternal and neonatal prognosis. Information was collected from a survey form in addition to clinical records, prenatal consultation booklet, registers (delivery room, operating room, postoperative, and postpartum planning register). Data were entered and analyzed through Word and Epi-Info version 7.2.4.0 software.Results: During the period of study, 4086 deliveries were recorded among which 1,325 cesarean section deliveries. 173 twin deliveries were recorded corresponding to a frequency of 4.23%. The average age was estimated at 29 years [16-42 years] with the average parity reaching 2 [0-9]. Married women represented 54.91% of the total number of patients. Family twinning notion was found in 94.22% of cases and the use of ovulation inducer sin 5.78% of cases. The twin pregnancy average term was 38 weeks of amenorrhea. Excessive uterine height was the most common reason for hospital admission. The first twin was in a cephalic position in 71.68% of cases. Vaginal delivery was performed in 63% of cases of twin pregnancy against 26.01% of cesarean section delivery. As for the type of twinning, the twin pregnancy was dichorionic-diamniotic in 68.22% of cases, monochorionic-monoamniotic in 4.62% of cases and monochorionic-diamniotic in 27.16% of cases. Neonatal complications were related to prematurity and neonatal distress. We observed 12 neonatal deaths (3.70%). Maternal complications were observed in 12.13% of cases with a predominance of anemia, severe preeclampsia and endometritis. Maternal death was observed in 3 cases (1.72%).Conclusion: Twin deliveries are relatively frequent in our department because of medical evacuations. The presence of well-trained practitioners is necessary for the evaluation of the maternal and fetal situations in order to make the relevant decisions. A good knowledge of obstetrical maneuvers is essential for the delivery of the second twin which requires an active attitude to increase the chances of successful rescue of the latter. In case of pathologies associated with twin pregnancy, prematurity, dystocia presentation of one or both twins, the onus lies on the obstetrician to make the most life-saving decisions to reduce the morbidity and mortality of the mother and the newborns.
Rita D, Ujwala P, Pavithra K
International Journal of Clinical Obstetrics and Gynaecology, Volume 6, pp 75-78; https://doi.org/10.33545/gynae.2022.v6.i2b.1164

Abstract:
Introduction: Provision of effective post gynaecological pain relief with minimal side effects is a major concern for any gynaecologist. For decreasing post-operative pain various methods and medications are used, of which opioids and NSAID’S are cost effective and are very commonly used. This study was designed to evaluate efficacy of these two drugs in post operative gynaecological pain relief in women. Aims and Objectives: To study the efficacy and duration with intravenous and rectal suppository drug administration and to study the presence of side effects, if any. Methods: This is a comparative study where in 150 patients undergoing gynaecological surgeries were included in the study to receive either Tramadol 100mg intravenously (Group A) or diclofenac rectal suppository (Group B) at the end of surgery. First onset of pain, VAS score, rescue analgesic requirement and side effects if any were noted. Conclusion: In the present study, diclofenac rectal suppository provides effective and better analgesia in acute post gynaecological pain than Intravenous tramadol with fewer side effects.
M Sangeereni, K Latha, Lekshmi Ts
International Journal of Clinical Obstetrics and Gynaecology, Volume 6, pp 31-35; https://doi.org/10.33545/gynae.2022.v6.i2a.1160

Abstract:
Background and Aim: Diabetes mellitus is one of common disease which is complicating pregnancy worldwide. Adverse neonatal outcomes associated with diabetes are of wide range. Cerebroplacental ratio (CPR) is a simple tool that can be calculated by Doppler hence using CPR as tool to predict neonatal outcome would be great scope in future. Hence present study aimed at to evaluate the cerebroplacental ratio (CPR) as a predictor of neonatal outcomes in pregnancies complicated by diabetes mellitus. Materials and Methods: It’s a prospective observational study at our tertiary care centre of 100 pregnant women who are diagnosed with overt or gestational diabetes mellitus. Cerebroplacental ratio is calculated. 100 cases were subdivided into 2 groups by calculating CPR Z score.i) Z score positive group with individual CPR ratio greater than mean (70 cases) ii) Z score negative group with individual CPR ratioResults: Cerebroplacental ratio less than 1.3 (negative Z score) is associated with bad neonatal outcome. Mean gestational age of delivery is lower (less than 37 weeks) in negative CPR Z score group in compared to more than 38 weeks in positive CPR Z score group. Pulsatility index of MCA is significantly lower in negative group than positive group with mean index of 1.23 in negative group and 1.55 in positive group. Pulsatility UA index is significantly higher in negative group than positive group with mean index 0.978 in negative group and 0.62 in positive group. Mean CPR z score is 1.224 for negative group and 2.57 score for positive group. Negative Z score group falls below 11th percentile and positive z score group falls above 86th percentile. Antenatal complications is significantly higher in negative group especially IUGR and oligohydramnios than positive group. Intrapartum complications are also significantly higher in negative group especially fetal distress. Bad neonatal outcomes are less in positive CPR Z score group like admission to Nicu, low Apgar, and low birth weight. Conclusion: Doppler cerebroplacental ratio is a better predictor of adverse perinatal outcome compared to Pulsatility index of umbilical artery or Pulsatility index of middle cerebral artery in singleton high risk pregnancy. There is no significant association between cerebroplacental ratio and pregnancy complicated by overt or gestational diabetes mellitus but CPR ratio less than 1.3 is associated with worse neonatal outcome. CPR ratio is less in pregnancy complicated by overt diabetes compared to gestational diabetes. Patients treated with insulin had less CPR ratio compared to patients on oral hypoglycaemic agents than on medical nutrition therapy. A less CPR ratio is associated with early gestational age of delivery. Ante partum complications like IUGR, oligohydramnios, Intrapartum fetal distress and postpartum complications like NICU admission, low birth weight and low Apgar are associated with low CPR ratio.
Preetinder Kaur, Alka Sehgal, Rupinder Kaur, Rinku Mehmi, Manpreet Kaur, Lokesh Kumar, Lucky Rana, Monika Thakur
International Journal of Clinical Obstetrics and Gynaecology, Volume 6, pp 47-49; https://doi.org/10.33545/gynae.2022.v6.i2a.1163

Abstract:
Genetic testing is defined as the tests to detect or exclude an alternation likely to be associated with a genetic disorder. It is different from the other tests done in clinical practice. These tests are performed either before or after birth, to identify genetic disorders. This is a cross-sectional study which has been conducted to assess the level of knowledge and attitude regarding prenatal genetic testing among antenatal mothers visiting antenatal OPD of GMCH-32, Chandigarh. The objectives of this study were to assess the level of knowledge and attitude of the antenatal mothers regarding genetic testing and to assess the association of knowledge with selected socio-demographic variables. The research design for this study was non experimental. Permission was taken from department of OBG and ethical clearance from institute, consecutive sampling technique was applied to select 65 antenatal mothers attending the antenatal OPD. Tool used for data collection was divided into 3 parts: Part-A Socio-demographic data and maternal profile, Part-B Questionnaires to assess level of knowledge regarding genetic testing and Part-C Likert scale to assess the attitude of antenatal mothers regarding genetic testing. The analysis was done by using descriptive and inferential statistics. The findings of the study revealed that the maximum mothers belong to the age group of 26-30 years. Out of 65 samples, 3% had excellent, 26% had good, 65% had average and 6% had poor knowledge. 100% has positive attitude regarding prenatal genetic testing.
Rita D, Gowthami K, Lathasri A
International Journal of Clinical Obstetrics and Gynaecology, Volume 6, pp 105-108; https://doi.org/10.33545/gynae.2022.v6.i2b.1171

Abstract:
Introduction: Postpartum haemorrhage remains a leading cause of maternal mortality (25.0%) especially in developing countries. Prolonged third stage of labour owing to placenta retention and uterine atony are among the underlying cause of most cases of PPH. Intraumbilical vein injection (IUV) is inexpensive, non-surgical, non-aggressive, cheap and pharmacological method which may be included in prevention and treatment of PPH and in retained placenta.Objectives: To study the efficacy of intraumbilical vein injection of 20 IU oxytocin with comparison with normal saline and its effect of duration of 3rd stage of labour, reduction of blood loss and incidence / prevention of retained placenta.Methods: A RCT of 80 Patients in normal labour at NMCH&RC. Study group (group A - 40) will receive 20 IU(4ml) oxytocin diluted with 26 ml of normal saline intraumbilically (total 30ml) and the control group (group B - 40) will receive intraumbilical 30 ml normal saline. Medications are given directly in the umbilical vein after clamping, injection given over 1 minute. Active management of the third stage of labour (prophylactic injection of 10 IU oxytocin within 2 minutes of birth, early clamping of the umbilical cord and controlled cord traction) was used in both groups. Results: The mean estimated blood loss was significantly lower in women treated with oxytocin compared with women in the normal saline group (148.35 ml compared with 364.50 mL, respectively; P< .001). The third stage of labour was significantly shorter in the oxytocin group than in the normal saline group (2.33 minutes compared with 5.20minutes, respectively; P< .001). The percentages of placentas remaining undelivered beyond 15 minutes were 0% in both the groups. Conclusion: The use of intraumbilical injection of oxytocin with the active management of the third stage of labour significantly reduced postpartum blood loss and the duration of the third stage thereby decreasing maternal morbidity and mortality and incidence of blood transfusion.
Kiridi Ek, Oriji Pc, Abasi Ij, Ubom Ae, Ugwoegbu Ju
International Journal of Clinical Obstetrics and Gynaecology, Volume 6, pp 22-30; https://doi.org/10.33545/gynae.2022.v6.i2a.1159

Abstract:
Background: Despite the development of other diagnostic tools such as hysteroscopy, laparoscopy, and magnetic resonance imaging, hysterosalpingography remains the most commonly used diagnostic modality for evaluating tubal patency in infertile women.Objective: To determine the predictive factors for abnormal findings in infertile women undergoing hysterosalpingography.Materials and Methods: This prospective, descriptive, cross-sectional study, was conducted at the Infertility Clinics and Radiology Departments of the Federal Medical Centre, Yenagoa, and Niger Delta University Teaching Hospital, Okolobiri, both in Bayelsa State, Nigeria, between January 2021 and July 2021. Hysterosalpingography was done for 350 eligible women, after obtaining written informed consents from them. Data were analysed using Statistical Product and Service Solutions for Windows® version 25. Results were presented in frequencies and percentages for categorical variables, and mean and standard deviation for continuous variables. Student’s t-test was used to compare sample means, and Chi-square, for associations. Bivariate and multivariate logistic regression analyses were used to determine the relationship between variables and abnormal hysterosalpingography findings. P-value <0.05 was considered statistically significant.Results: Secondary level of education (OR–5.97; p=0.007), secondary infertility (5.27; p=0.001), duration of marriage (6–10 years: OR–4.36; p=0.001), duration of infertility (6-10 years: 6.94; p=0.001) and induced abortion (OR–11.73; p=0.001) were significantly associated with abnormal hysterosalpingography findings.Conclusion: Our study established that the predictors of abnormal findings on hysterosalpingography were secondary level of education, secondary infertility, duration of marriage, duration of infertility and induced abortion.
Itishree Panda, Panchanan Das, Karuna Kanta Das
International Journal of Clinical Obstetrics and Gynaecology, Volume 6, pp 240-244; https://doi.org/10.33545/gynae.2022.v6.i1d.1149

Abstract:
Objective: Obstructed labor comprises one of the five major causes of maternal mortality and morbidity in developing countries. Perinatal asphyxia due to obstructed labor not only lead to neonatal deaths, also accounts for a significant proportion of stillbirths. This study has been done to assess socioeconomic factors, clinical profile and to evaluate fetomaternal outcome in obstructed labor cases from a developing country perspective. Study design: This hospital based observational study was conducted at Gauhati medical college and hospital (GMCH), Guwahati, India for one year. All the obstructed labor cases admitted during this period (1st June 2019 to 31st May 2020) were enrolled in the study and evaluated. Results: Out of total 18768 deliveries 210 cases were diagnosed as obstructed labor, incidence being 1.12%. The mean age of our study population was 22.4 ± 5.4 years. Majority patients were from rural areas (89.50%), belonged to lower middle socioeconomic class (60.9%). Unbooked cases comprised 80% of the study population. Mean duration of stay in referral center before being referred to our institution was 22.1 ± 5.6 hours. Most common cause of obstructed labor was cephalopelvic disproportion (CPD) (57.6%). Incidence of CPD was significantly higher in nulliparous cases (p value <0.0001) whereas incidence of malposition and malpresentation was significantly higher in multiparous (p value <0.0001). Sepsis was the commonest maternal complication (36.2%) and birth asphyxia was the commonest neonatal complication (44.64%). Conclusion: Lack of patient’s education, inadequate antenatal care and skills in the peripheral health care setup along with poor referral facilities are responsible for most cases of obstructed labor in our study.
Jahnavi Singh, Manisha Behal, Neerja Singhal, Rajeev Vinayak, Santosh Minhas
International Journal of Clinical Obstetrics and Gynaecology, Volume 6, pp 226-228; https://doi.org/10.33545/gynae.2022.v6.i1d.1143

Abstract:
Introduction: Obstetric emergencies are developed unexpectedly and demand immediate attention in order to save life. Obstetric emergencies are the leading cause of maternal mortality worldwide and particularly in developing countries due to lack of awareness and adequate health facilities.Objective: Present study aims to analyse the maternal and fetal outcomes in obstetrical emergencies admitted to labour room in a north region hospital center. Methods: Total 115 obstetric patients presenting to the obstetric emergency ward were evaluated for mode of delivery, maternal outcome, ICU admission, maternal mortality and NICU admission and fetal outcomes. Results: Preterm vaginal delivery was higher in booked pregnancies compare to unbooked. Fetal mortality rate was also low in booked pregnancy compared to unbooked. In booked pregnancies, no newborn requires the NICU admission whereas in unbooked pregnancies 30.12% newborns requires the NICU admission.Conclusion: To handle an obstetric emergency, it is essential that the patients should be already in the follow up with the hospital. Early reference to health care center can help in better management of obstetric emergencies which in turn can enhance the maternal and fetal outcomes.
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