Abstract

Objectives: To study the role of bilateral uterine artery (UA) diastolic notch and resistance index at 12-16 weeks of gestation for early prediction of pre-eclampsia using transvaginal color Doppler imaging.

Methods: Hundred antenatal women with singleton pregnancy at 12-16 weeks of gestation were considered for the study. Transvaginal Doppler study of uterine circulation was performed, diastolic notch and various velocimetry indices were noted and compared for significant, difference between normal and abnormal outcome group. The sensitivity, specificity, positive predictive value and negative predictive value were calculated for diastolic notch and notch with resistance index (RI)

Results: Pre-eclampsia developed in 31.42% of the women with bilateral (UA) diastolic notch at 12-16 weeks. Detection rate increased upto 56% when RI > 0.65 was also included in abnormal uterine artery waveform. Specificity increased from 66.4% to 84.7% and sensitivity from 68.75 to 87.5%.

Conclusions: Uterine artery Doppler study between 12-16 weeks is a good screening method for identification of women at high risk of developing complication related to utero-placental insufficiency.

Abstract

Objectives: Implementing Robson’s ten group classification (TGCS) to analyze Cesarean section (C-section) rate. Methods: The TGCS divides women in ten groups based on the category of pregnancy, previous obstetric records, course of labor and delivery and gestational age. C-Section rates within each group and contribution of each group to the total C-section rate were calculated. Depending upon the result of 2006, a prospective study was conducted in 2007 and groups with high cesarean rate were scrutinized and efforts made to reduce the rate wherever possible. Statistical analysis was done by chi-square test.

Result: The contribution of group 1, 2, 3 and 5 in the year 2006 was 10%, 2.2% 1.6% and 8.2% respectively and the contribution in 2007 was 8.3%, 1.6%, 0.5% and 6.6% respectively (p<0.05). The overall C-section rate became 20.7% in 2007 which was 26.2% in 2006.

Conclusion: TGCS provides helpful information in the assessment of C-section rate and if successfully implemented, will lead to acceptable cesarean rate.

Abstract

Objectives: To study the incidence, clinicopathological characteristics, and prognosis of skin metastases in patients suffering from genital malignancy.

Methods: A retrospective review of 1012 patients with different types of genital malignancies was undertaken in our tertiary center. Relevant clinicopathological information, treatment of primary site and documentation of skin metastases were noted. Survival time was calculated from the time of diagnosis of skin metastasis.

Results: Out of the 1012 patients only nine patients (four suffered from carcinoma cervix and five from ovarian carcinoma) had skin metastases. The average time of appearance of skin metastasis after diagnosis of primary malignancy was 18.9 months. Six patients died of the disease. Two patients are still alive. One patient did not follow up. Median survival time after diagnosis of skin metastasis in eight cases was 4.5 months.

Conclusions: Skin involvement occurs rarely in genital malignancy. Prognosis after skin metastasis is poor.

Abstract

Objectives: To evaluate various clinical, laboratory and radiological tests of ovarian reserve available for prediction of successful ovulation induction in infertility.

Methods: The study comprised of 54 infertile women, who underwent evaluation of various clinical, biochemical and sonological parameters for the assessment of ovarian reserve i.e. measurement of day-3 serum FSH levels, clomiphene citrate challenge test (CCCT) and number of antral follicles. Outcome variables were S. estradiol levels and endometrial thickness at the time of ovulation trigger, presence of ovulation, S. progesterone levels 7 days after ovulation trigger and pregnancy rate.

Results: Among the various tests used CCCT was found to be a better predictor of ovarian reserve. There was statistically significant decrease in the levels of S. estradiol, S. progesterone and endometrial thickness in patients with abnormal CCCT. No pregnancy occurred in cases with abnormal CCCT.

Conclusion: CCCT was found to be better than D-3 FSH or number of antral follicles to predict ovarian reserve. Assessment of ovarian reserve is important for prediction of outcome prognosis of ovulation induction as diminished ovarian reserve is associated with suboptimal response to ovulation induction.