Journal of Obstetric and Gynaecological Practices POGS

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2024 | January-June | Volume 2 | Issue 1

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EDITORIAL

Sushil Chawla

Obesity and Obstetrics

[Year:2024] [Month:January-June] [Volume:2] [Number:1] [Pages:2] [Pages No:1 - 2]

Keywords: Body mass index in pregnancy, Complications of obesity, Maternal health, Maternal obesity, Nutrition

   DOI: 10.5005/jogyp-11012-0028  |  Open Access |  How to cite  | 

79

Original Article

Kranti K Kulkarni, Mansi Kumar, Soniya Nagar, AS Dhillon

Analysis of Increasing Cesarean Section Rate by Robson's 10-group Classification System in a Tertiary Care Public Charitable Hospital in Haryana

[Year:2024] [Month:January-June] [Volume:2] [Number:1] [Pages:5] [Pages No:3 - 7]

Keywords: Cesarean section, High-risk pregnancy, Maternal outcome

   DOI: 10.5005/jogyp-11012-0030  |  Open Access |  How to cite  | 

Abstract

Over the past few decades, delivery by cesarean section (CS) has increased dramatically in most of the countries. Rising CS rates are a major public health concern and leading worldwide health debate regarding potential causes of increased maternal and perinatal morbidity and mortality, associated with cesarean section. Robson's 10-group classification system (RTGCS) helps us to identify the main groups of subjects who contribute most to the overall CS rate. A retrospective cross-sectional study was carried out over 1 year from November 21, 2022 to November 20, 2023, in the mother and child health unit of a tertiary care charitable hospital of Palwal, Haryana: Shree Satya Sai Sanjeevani Hospital and Research Center. Being a tertiary care center with NO BILLING POLICY, Shree Satya Sai Sanjeevani Hospital and Research Center automatically eliminates unnecessary C-sections, thereby adhering to standard treatment guidelines. Also, indications like CS on demand or unindicated LSCS are not entertained as per the ethical standards of our institution. Using the RTGCS, we audited all admissions and appreciated that the incidence of cesarean delivery in our setup was 52.1%, exceeding the set standard by World Health Organization (WHO), by approximately 15%. However, these rates are comparable with other similar studies in India. Our study also reflects the need to define separate standards for maternal outcome and mode of delivery depending upon the level of care…primary or tertiary center, with many referrals for high-risk obstetrics.

87

Original Article

Deepti D Kadam, Bhakti Gurjar

Diagnosis Based Technique of Hysterectomy: Comparison among Laparoscopic and Nondescent Vaginal Hysterectomy

[Year:2024] [Month:January-June] [Volume:2] [Number:1] [Pages:4] [Pages No:8 - 11]

Keywords: Cesarean section, Hysterectomy, Nondescent vaginal hysterectomy, Obstetrics, Total laparoscopic hysterectomy

   DOI: 10.5005/jogyp-11012-0025  |  Open Access |  How to cite  | 

Abstract

Objectives and background: The objectives of this investigation encompass the indications prompting uterine removal for various medical reasons. The current inquiry systematically examines the factors influencing the decision for hysterectomies and subsequently reports the corresponding clinical outcomes. The primary aim is to conduct a comparative analysis of clinical results between two methods of hysterectomy, namely total laparoscopic hysterectomy (TLH) and nondescent vaginal hysterectomy (NDVH). Materials and methods: This comparative study, conducted in a Tertiary Care Center, meticulously considers crucial intraoperative parameters, such as operating time, blood loss attributable to the procedure, and bladder/bowel injury, as well as pain scores assessed by the visual analogue scale (VAS), in conjunction with the duration of hospital stay. Statistical analyses include the application of the Chi-square test and other fundamental statistical procedures. Results: With an average age of 46 years, it was observed that the time required for performing TLH was significantly shorter than NDVH. Similar trends were identified in parameters such as blood loss, and postoperative pain scores at the 3rd hour, 1st day, and 2nd day. The total hospital stay (in days) for NDVH was notably longer compared to TLH. Discussion: The findings of the present study suggest that under optimal conditions, including suitable facilities, surgical expertise, and proper indications, TLH could be considered the preferred route for hysterectomy. Conversely, in a developing nation like India, NDVH offers a distinct advantage, especially when considering the specific indications for surgery, making it the preferred route for benign uterine conditions. Conclusion: The study concludes that the choice of the hysterectomy route may be contingent upon the specific circumstances of the procedural location. Clinical significance: The decision regarding the appropriate route for the operation can be made with careful consideration of the factors elucidated in this study.

71

Original Article

Srikonda Yashaswini, Shripad Hebbar

An Observational Study of Effect of Umbilical Cord Entanglement on Mode of Delivery and Perinatal Outcome

[Year:2024] [Month:January-June] [Volume:2] [Number:1] [Pages:4] [Pages No:12 - 15]

Keywords: Cesarean section, Instrumental delivery, Perinatal outcome, Umbilical cord entanglement, Vaginal delivery

   DOI: 10.5005/jogyp-11012-0024  |  Open Access |  How to cite  | 

Abstract

Background: Cord entanglement is the most common cord abnormality detected in modern obstetric practice and is one of the reasons for the increase in cesarean section rate. The aim of our study is to detect the incidence of cord entanglement and effect on perinatal outcomes. Materials and methods: Our study is a prospective observational study conducted in a tertiary center over a period of 2 years. A total 375 patients were enrolled for the study, over a 2-year period. Among 375 patients, 257 control without cord entanglement, and 118 had cord entanglement. Results: In the cord entanglement group, 56.8% normal delivery, 15.3% instrumental delivery, and 33% emergency LSCS. In the group without cord entanglement, 77% has a normal delivery, 10.1% instrumental deliveries, and 12.8% emergency LSCS. Low APGAR scores at 1 and 5 minutes and NICU admission were high in the group with cord entanglement as compared to the group without cord entanglement and more significantly in the tight entanglement group. Conclusion: We conclude that pregnant women with cord entanglement require intense observation and close monitoring of labor with partogram and continuous fetal monitoring with cardiotocography to note any adverse events immediately during labor and to expedite delivery if necessary either by instrumental delivery or cesarean section to prevent neonatal compromise. But a fair trial for vaginal delivery can be given and the mother should not be stressed with unnecessary anxiety when cord entanglement is noted on ultrasonography.

74

Original Article

Ankita Pandey, Shweta Joshi

Provision of Postnatal Contraception Survey in a District Hospital in the United Kingdom

[Year:2024] [Month:January-June] [Volume:2] [Number:1] [Pages:3] [Pages No:16 - 18]

Keywords: Contraception, Fertility, Perinatal outcome

   DOI: 10.5005/jogyp-11012-0023  |  Open Access |  How to cite  | 

Abstract

In the UK, approximately 1 out of every 13 women seek abortion services within the year following childbirth. World Health Organization (WHO) recommends at least 2 years’ inter-pregnancy interval. Guidance from the Faculty of Sexual and Reproductive Healthcare suggests discussing all kinds of contraception in the antenatal period to support informed decision-making. An anonymous, voluntary cross-sectional survey of women in the postnatal ward was conducted with the help of a questionnaire over a period of 6 weeks. The questionnaire mainly focused on past contraception usage, knowledge and awareness regarding contraception and safe inter-pregnancy interval, and their future intentions. The results depicted a lack of key information among women to enable them to decide regarding their use and choice of contraceptive method. Almost 37% of women surveyed preferred contraception provision on the postnatal ward before discharge.

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Original Article

Jijisha Ali, Anita Eipe

Correlation of Laparoscopically Managed Adnexal Masses with Clinical Examination and Ultrasound Findings

[Year:2024] [Month:January-June] [Volume:2] [Number:1] [Pages:4] [Pages No:19 - 22]

Keywords: Clinical examination, Endometriosis, Laparoscopy, Ovarian masses

   DOI: 10.5005/jogyp-11012-0021  |  Open Access |  How to cite  | 

Abstract

Purpose: To analyze laparoscopic findings of adnexal masses and correlate them with clinical examination and ultrasound findings. Study design: Retrospective observational study. Setting: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, Karnataka, India. Sample size: A total of 137 subjects. Duration of study: From May 2012 to April 2013. Inclusion criteria: All women admitted with clinical suspicion of adnexal masses. Exclusion criteria: Women with suspicion of malignant ovarian masses. Materials and methods: This is a retrospective observational study carried out in the Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, Karnataka, India during the period from May 2012 to April 2013. A total of 137 patients who underwent laparoscopy for suspected adnexal masses were included in this study. Case records of these patients were retrospectively analyzed, and detailed clinical examination and ultrasound findings done were noted. These findings were correlated with laparoscopic findings. Results: In the study group, 98.3% of cases of endometriosis clinically correlated with laparoscopic findings whereas ultrasound correlated with only 93.7% of endometriosis. Similar correlations were observed in benign ovarian masses on clinical examination and ultrasound, 89.3 and 96.4%, respectively. Similarly, ectopic pregnancies diagnosed by clinical examination correlated with laparoscopy in 93.8% of cases whereas ultrasound findings correlated only in 90.6% of cases. All the cases of paraovarian cysts were missed in clinical examination, whereas ultrasound detected 20% of cases. In suspected cases of pelvic inflammatory disease, ultrasound diagnosed hydrosalpinx in 66.7%, whereas clinical examination failed to diagnose. Ectopic pregnancy was either missed or not suspected when patients presented with acute abdomen to another specialty (Department of Surgery). Conclusion: Laparoscopic findings correlated with clinical examination and ultrasound in endometriosis, ectopic, and ovarian masses. Paraovarian cysts were either not suspected or misdiagnosed as ovarian cysts during clinical examination whereas ultrasound diagnosed one-fifth of cases. Take-home message: Laparoscopy is useful when simultaneous therapy can be offered, not as a diagnostic tool alone.

76

Original Article

Bali N Thool, Sunita Shrivastav

To Assess and Evaluate the Premenstrual and Menstrual Comprehensive Symptoms Scale for Grading the Menstrual Problems among Adolescent Girls

[Year:2024] [Month:January-June] [Volume:2] [Number:1] [Pages:5] [Pages No:23 - 27]

Keywords: Adolescent's girls, Comprehensive menstrual symptoms, Gynecology, Menstruation, Obstetrics

   DOI: 10.5005/jogyp-11012-0026  |  Open Access |  How to cite  | 

Abstract

Adolescence is defined by the World Health Organization (WHO) as the period between the ages of 10 and 19. In India, adolescents make up 19.3% of the population. The onset of menarche marks this era. Menstrual cycle disorders or irregularities rank among the most common gynecological issues among adult females, particularly adolescents. The target population's most common menstrual issues include dysmenorrhea and premenstrual symptoms. In India, only 48% of teenage females know anything about menstruation before their first period. Extensive research instruments were not employed in the investigation to assess menstrual issues. Objective of study: • To assess the grading of premenstrual symptoms and menstrual symptoms. • To assess the premenstrual and menstrual symptoms score for different variables. • To check the reliability of the scale. Material: A standardized self-made comprehensive scale used. Research design: Observational, correlational, Interventional study. Techniques: Purposive sample technique. Sample size: A total of 12 adolescent girls in Wardha schools. Result: The study finding shows that a total of 12 samples are involved in the study of Premenstrual symptoms, and physical symptoms with a mean 24.8333, standard deviation 14.55918, minimum 14.00 and maximum 62.00, affective symptoms with mean 2.2500, The average symptoms are 3.36087, minimum and maximum values are 10.00; the average behavior and concentration symptoms are 0.6667, minimum and maximum values are 5.00; the average negative symptoms are 10.4167, minimum and maximum values are 8.00 and 19.00; the average PMDD symptoms are 27.5833, minimum and maximum values are 20.00 and 50.00; the average combined symptoms are 11.7500, minimum and maximum values are 7.00 and 30.00. For menstrual symptoms, physical symptoms were recorded with a mean of 26.7500, standard deviation: Of 14.89432, with minimum of 14.00 and maximum of 55.00 Average of 5.5833, standard deviation of 5.17790, lowest of 0.00, maximum of 15.00, were recorded for affective symptoms. Focus and conduct indicators were noted with an average of 1.1667, standard deviation of 2.51661, lowest 0.00, and highest 7.00, PMDD was assessed with a mean 6.3333, standard deviation of 3.82179, minimum of 3.00 and maximum of 16.00, and standard deviation of 4.83281, minimum 7.00 and maximum 21.00. Negative symptoms were reported with mean of 10.4167, PBAC with a mean 5.5833, standard deviation 1.31137, minimum 4.00 and maximum 8.00. The mean and standard deviation of dysmenorrhea were 12.3333, 3.86907, and 10.00 and 23.00, respectively, for the minimum and maximum values. The mean for menorrhagia was 5.5833, standard deviation of 1.31137, minimum of 4.00 and maximum of 8.00 and amenorrhea was recorded with a mean of 0.0, standard deviation 0.0, minimum 0.00 and maximum 0.00. Conclusion: According to the findings of the current study, premenstrual and menstrual symptoms scores for various variables are meaningful and can be used to gauge menstrual issues. A thorough teaching program on menarche and menstrual issues in schools could support girls in seeking appropriate medical care and coping more effectively.

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CASE REPORT

Ankita Pandey, Nosheen Akhtar, Joseph Mechery

Isolated Fallopian Tube Torsion: A Rare Cause of Acute Abdomen

[Year:2024] [Month:January-June] [Volume:2] [Number:1] [Pages:2] [Pages No:28 - 29]

Keywords: Acute abdomen, Case report, Fertility, Gynecological laparoscopy, Gynaecology, Hydrosalpinx, Torsion, Tubo-ovarian abscess

   DOI: 10.5005/jogyp-11012-0022  |  Open Access |  How to cite  | 

Abstract

We present a rare case of acute abdominal pain in a nulliparous woman: Isolated fallopian tube torsion (IFTT). A 39 years nulliparous woman came with a two-day history of acute, constant left lower abdominal pain. The pelvic ultrasound was suggestive of a tubo-ovarian abscess. On laparoscopy, a torted left gangrenous fallopian tube was noted. The histology was suggestive of salpingitis-isthmica-nodosa.

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Quiz

Rajesh Mishra

Quiz

[Year:2024] [Month:January-June] [Volume:2] [Number:1] [Pages:1] [Pages No:30 - 30]

   DOI: 10.5005/jogyp-11012-0027  |  Open Access |  How to cite  | 

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