Background Maternal health in India is likely to move towards an obstetric transition, wherein there is sustained reduction of maternal mortality and focus shifts towards improving quality of care. In such a context, reproductive concerns of special populations gain prominence. One such population group is women with disability.

What this review contains This mini-review examines the incremental importance given to people with disabilities and the sparse data available on the topic of reproductive concerns among women with disability. The attitudes of the women with disability towards childbearing and the association between disability and obstetric problems are discussed. The limited available data on specific medical and obstetric problems among women with disability are reviewed.

Conclusions The article calls for all obstetricians to display increased sensitivity and heightened cognizance towards the reproductive concerns among women with disability.

Introduction Gestational diabetes is defined as the carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Gestational glucose intolerance (GGI) is used to indicate pregnant women whose 2-h postprandial glucose is > 120 mg/dl and below 140 mg/dl (Diabetes in Pregnancy Study Group of India, DIPSI criteria). Aim This study was planned to see whether intervention in GGI group helps to improve feto-maternal outcomes.

Methodology This open-label randomized control trial was conducted in Department of Obstetrics and Gynaecology of King George's Medical University, Lucknow. Inclusion criteria were all the antenatal women attending the antenatal clinic and diagnosed as GGI, and exclusion criteria were overt diabetes.

Results Total of 1866 antenatal women were screened, and among them, 220 (11.8%) women were diagnosed as gestational diabetes; 412 (22.1%) women were diagnosed as GGI. The mean fasting blood sugars in the women with GGI who had medical nutrition therapy were much lower than the women with GGI who did not have any intervention. The present study showed the women with GGI had higher complications like polyhydramnios, PPROM, foetal growth restriction, macrosomia, preeclampsia, preterm labour and vaginal candidiasis more in the women with GGI as compared to euglycaemic women.

Conclusion The present study of nutritional intervention in GGI group has shown trend towards lesser complication if we start medical nutrition therapy reflected by delayed development of GDM and less neonatal hypoglycaemia and hyperbilirubinemia.

Background The effectiveness and safety of pituitrin injection coupled with hysteroscopy and suction curettage as treatment for type I cesarean scar pregnancy (CSP) have not been studied enough in the literature, by comparing it to uterine artery embolization (UAE) followed by suction curettage we aim to determine its efficacy.

Materials and Methods Data of 53 patients (the PIT group) with type I CSP treated with pituitrin injection combined with hysteroscopic suction curettage and 137 patients (the UAE group) with type I CSP treated with UAE followed by suction curettage were collected in retrospect. The clinical data were analyzed statistically to compare the efficacy and safety between the two groups.

Results The PIT group had a shorter duration of postoperative vaginal bleeding, postoperative hospitalization, and overall hospitalization length (P < 0.05). The PIT group had lower overall hospitalization costs and a lower rate of adverse events than the UAE group (P < 0.05). There was no significant difference between the two groups in terms of treatment success rate, the average length of operation, blood loss during the procedure, time when serum β-hCG returned to normal range, and menstrual recovery time after hospital release (P > 0.05).

Conclusion UAE and pituitrin injection followed by hysteroscopic suction curettage are good choices for type I CSP treatment. However, pituitrin injection with hysteroscopic suction curettage outperforms UAE followed by suction curettage. Thus, pituitrin injection may be an option of high priority for type I CSP.

Background Tibolone is an alternative to conventional estrogen and progesterone in relieving post-menopausal symptoms in Indian women.

Material and Methods A prospective short-term observational study was done at a tertiary care teaching hospital in New Delhi from November 2019 to September 2021. Fifty-three women, less than 60 years of age, presenting with moderate to severe intensity of menopausal symptoms as assessed by measuring menopausal rating score (MRS > 8) were enrolled and given Tibolone 2.5 mg daily for 3 months. Improvements in symptoms were seen at 1 month and 3 months. Side effects were also noted.

Results Marked improvement was seen as reduction in scores of psychological, somatic and genitourinary symptoms was noted. The psychological symptoms reduced from 8.92 ± 1.959 to 2.905 ± 1.042, the somatic symptoms decreased from 8.33 ± 2.299 to 3.4 ± 1.167, and genitourinary symptoms decreased from 3.64 ± 1.42 to 2.150 ± 0.948 after 3 months of treatment with Tibolone. Only 3 patients (5.6%) experienced vaginal spotting with no major side effects.

Conclusions Tibolone is a highly effective and well accepted drug to reduce moderate to severe menopausal symptoms, especially psychological symptoms including depression.

Objective To test the validity of the novel Menstrual Health Index (MHI) in order to assess safety of menstrual health and hygiene practices in adolescents and young adults.

Methods This is a community-level prospective questionnaire-based study conducted in females between the age group of 11 and 23 years. The number of participants was 2860. The participants were asked to fill in the questionnaire pertaining to four components of menstrual health, viz., menstrual cycle, menstrual absorbents, psychosocial aspects and WASH component associated with menstruation. Based on the score assigned to each component, Menstrual Health Index was calculated. A score of 0–12 was considered poor, 12–24 was considered average, and 24–36 was considered good. Educational interventions were designed to improve the MHI in that particular population according to component analysis. After 3 months, MHI was rescored to see the improvement.

Results A total of 3000 females were handed over the proforma and 2860 females participated. Among participants, 45.4% were from urban area, rest were from rural areas (35.6%) and slum areas (19%). Majority of the respondents were in the age group of 14–16 years (62%). Poor MHI (0–12 score) was seen in 48%, average score (13–24) was found in 37%, and good score was found in 15% participants. When individual components of MHI were assessed, it was found that, as high as 35% of the girls had limited accessibility to menstrual blood absorbents, 43% skipped school for more 4 times in a year, 26% suffered from severe dysmenorrhea, 32% reported difficulty in maintaining privacy while using WASH facilities and 54% were using clean sanitary pads as menstrual sanitation option. Best composite MHI was observed in urban areas, followed by rural and then slum area. In urban area and rural area, menstrual cycle component score was least. In rural area, sanitation component score was least and in slum area, WASH component scored the worst. Severe premenstrual dysphoric disorder was recorded in urban area, and maximum abstinence from school due to menstruation was seen in rural areas. An improvement in score was seen in 87% of the girls (93% individual and 87% composite), after 3 months of education and interventional strategies.

Conclusion Menstrual health is not limited to cycle frequency and duration normalcy. It is a comprehensive subject, encompassing physical, social, psychological and geopolitical aspects. Assessing prevailing menstrual practices in a population, particularly in adolescents, is imperative to design IEC tools, and these objectives are aligned with SDG-M goals of Swachh Bharat Mission. MHI serves as a good screening tool to interrogate KAP in a particular area. Individual problems can also be addressed in a fruitful manner. Rights-based approach to provide essential infrastructure and provisions to promote safe and dignified practices to a vulnerable population like adolescents can be aided by using tools like MHI.

Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors, originating primarily from interstitial cells of Cajal of the gastrointestinal tract wall with the majority of them KIT (CD117)-positive. Due to their non-specific clinical presentation, they may present a diagnostic dilemma in women with abdominopelvic mass. The current manuscript presents an unusual case of GIST originating from the omentum, which was preoperatively presumptively diagnosed as an adnexal mass during routine gynecological and radiological evaluation. Also, it highlights the importance of the multidisciplinary coordinated approach for the optimal care of such patients.

Background Arteriovenous malformation of umbilical cord is an extremely rare congenital malformation. Causes of this condition are unknown. AVM of umbilical cord can cause significant complications in the developing fetus.

Methods We report our management of the case with accurate ultrasound study that could improve and facilitate the approach to this pathology due to the lack of literature and with an overview of the available literature.

Results There are only two cases of umbilical AVM diagnosed in the prenatal period with associated pathology. The mainstay of prenatal detection is the accurate study of umbilical cord also even if it is not requested from the actual guide lines in a way to improve the perinatal morbidity and mortality.