Objectives: To evaluate the prevalence of primary rubella infection in women with pregnancy wastage. Methods : The study included 150 pregnant women with obstetrical losses (Group 1) and 150 pregnant women without any obstetrical losses (group II). Serological evaluation for IgM antibodies was carried out by IgM ELISA method.
Results: Seropositivity for rubella was 8.67% in group I and 2% in group II. Seropositivity was found to be associated with abortions (2.67%), congenital malformations (14.28%), still birth (10%), intrauterine death (7.69%), Preterm delivery (25%) and intrauterine growth retardation (33.33%).
Conclusions: Seropositivity in women with obstetrical losses is statistically significant (p<0.05) as compared to those without any obstetrical losses. So routine screening of all pregnant women should be a part of antenatal check up.
Objectives: This study was undertaken to estimate the prevalence of Bacterial vaginosis (BV) in a rural and urban setup of Surat and to compare two methods of diagnosing the condition.
Methods: A total of 100 married women, 50 from urban and 50 from rural setup, who were in sexually active age group of 15-44 years, were selected. BV was detected by both Gram stain and accepted Gold standard compound criteria (Amsel’s composite criteria). High vaginal swabs were taken from posterior vaginal fornix pH of vaginal discharge was measured; wet mount preparation, Amine test (Whiff test) and Gram staining were performed. Results: BV was diagnosed in 20/100 patients by using composite criteria and in 28/100 patients by using Gram staining. Prevalence of BV in an urban setup was 30% and in a rural setup was 26%. Using Amsel’s criteria as standard, sensitivity, specificity, positive predictive value was 95%, 88%, 67.85% and 98.68% respectively.
Conclusion: Gram stain provides a simple and inexpensive method for confirmation of BV and can be used as an alternative to Amsel’s criteria.
Objectives: Pregnancy with epilepsy is indeed high risk pregnancy. The purpose of this study was to evaluate the feto-maternal outcome based on the type of epilepsy and treatment offered.
Methods: 49 pregnant women with epilepsy attending the antenatal clinic in a tertiary care hospital over a period of 3½ years were evaluated.
Results: Out of the pregnant women with epilepsy in this study, 6 patients were lost to followup, liveborn infants were delivered in 41 out of 43 pregnant women. Out of the 41 liveborn infants major congenital malformations were observed in two babies and minor anomalies in three. The use of anticonvulsants in our study was carbamazepine in 19(44.18%), oxcarbazepine in 7(16.3%), phenytoin in 9(20.4%), valproate in 5(11.6%), lamotrigine in 3 patients (6.9%). Conclusions: Out of the 43 pregnant women with epilepsy in this study, fetal loss and major malformations were observed in 4.65% cases each.
Objective: To increase access to safe abortion, the feasibility, efficacy and acceptability of a medical abortion regimen entailing a reduced dose of mifepristone and the option of home administration of sublingual misoprostol was assessed at a government hospital providing legal abortion services on a regular basis.
Methods: Consenting women (n=99) with amenorrhea of =56 days received mifepristone 200mg orally at the hospital. Two days later, women either returned to the hospital for 400µg sublingual misoprostol or took it at home. All women returned after two weeks for abortion confirmation. Results: The vast majority of women (88%) chose home use of misoprostol and did so mainly to decrease the number of clinic visits (65%) and to take care of their household responsibilities (16%). Adherence to the drug protocol was comparable among home and clinic users, with only a single woman in each group not taking misoprostol at the scheduled time. Efficacy was similarly high in both groups (home users 95% vs. clinic users 96%). No serious side effects were noted in either home or clinic users.
Conclusion: The safety, efficacy and acceptability of home use of misoprostol observed in our study suggest this option should be available to women in India.
Objectives: To assess, evaluate and compare the safety and efficacy of intramuscular PGF2a 125mg and intravenous 0.2mg methylergometrine during active management of third stage of labor in high risk women who are prone to develop atonic postpartum hemorrhage.
Methods: Two hundred women at high risk factors of developing atonic PPH were divided into two groups. In group 1 PGF2a 125mg was given intramuscularly and in group II methylergometrine 0.2mg was given intravenously at the delivery of anterior shoulder prophylactically. Duration of third stage of labor, amount of blood loss, side effects of drugs used and complications if any were noted and analyzed. Tools of statistical analysis used were Paired ‘t’ test, ‘Z’ test and mean ± SD. Results: The mean duration of the third stage of labor after giving uterotonic drug was significantly shorter in group I (2.634±0.975min) as compared to group II (3.342±0.876min) P<0.001. The mean blood loss was significantly less in group I 111.4±65.3ml versus 169±112 ml in group II (P<0.001). There was no significant rise in BP in group I as compared to group II. The only significant side effect was diarrhea in group I.
Conclusions: Prophylactic intramuscular PGF2a125mg is a better alternative to prophylactic intravenous methylergometrine 0.2 mg in high risk women who are more prone to develop atonic PPH. prophylactic PGF2a, prophylactic methylergometrine, high risk women, atonic PPH
Objectives: The purpose of this study was to evaluate the changing trends of acceptance of different methods of family planning during the five years from 2001-2005 and at the same time to analyze the acceptance of MTP as a means of fertility control over a period of five years.
Methods: The present study is a retrospective one carried out in the Department of Obstetrics and Gynecology, Medical College Kolkata from January 2001 to December 2005. Fourteen thousand six hundred seventy seven patients who have accepted different methods of family planning with or without MTP were included. The number of patients accepting different methods of family planning was determined and simultaneous study was done with reference to their age, number of living children, marital status, religion, literacy status and timing with method of ligation. Results: Yearly acceptance of OCP showed a slight upward trend and that of ligation showed a downward trend, whereas that of CuT remained almost constant. It is evident that number of patients undergoing MTP showed a gradual but steady decrease over years.
Conclusion: The downward trend of MTP and increased acceptability of OCP as noticed in our study is undoubtedly a welcome sign and increased familiarity with the newer methods of contraception will promise to brighten up the culture of family planning practices.
Objectives: To study the effects of tamoxifen use on endometrium, myometrium, and adnexae in patients with breast carcinoma on tamoxifen therapy.
Methods: Study group (n=25) included patients of breast carcinoma on tamoxifen therapy, control group (n=50) included age matched breast carcinoma patients not on tamoxifen therapy and women with no gynecological problems. Transvaginal sonography (TVS) was performed in them. Symptomatic patients or with abnormal TVS findings had endometrial aspiration biopsy. Results : 44% in study group had abnormal TVS findings as compared to 2% in control group (p value<0.001). The mean endometrial thickness was higher in study group (p value =0.001). 60% in study group with abnormal histopathology were asymptomatic. Incidence of thickened endometrium in patients on tamoxifen for <5 years was 31.57% as compared to 16.67% for >5 years.
Conclusion: Study confirms potential side effects of tamoxifen in asymptomatic breast carcinoma patients, especially postmenopausal. There is a definite need for routine monitoring and availability of a safer adjuvant agent with similar efficacy.
It was a cross sectional study. A pretested semi-structured questionnaire was used. The information was collected using interview technique. Study period was from June 2006 to October 2006. It was decided to cover more than 500 women attending teaching hospital for their delivery during study period. However, a total of 991 women came to avail the services and 600 women were interviewed after the delivery. Their details of socio-demographic features were enquired in addition to the questions related to their fertility behaviour. The data were analysed with the help of Window based EpiInfo software (version. 3.2).
Objectives : Chronic pelvic pain (CPP) is best defined as the non menstrual pelvic pain for at least six months, which is severe enough to cause functional disability and require medical or surgical treatment. A thorough clinical examination no doubt provides a gynecologist with considerable information but that is not sufficient in arriving at the diagnosis or pinpointing the cause of CPP in all cases. Ancillary aids like imaging studies and direct visualization of the pelvic organs by laparoscopy are often required. In this study we made an endeavor to find out the role of laparoscopy in the evaluation of CPP. Methods : The present study was conducted in the department of Obstetrics and Gynecology, Medical College and Hospital, Kolkata from January 2006 to December 2006. All the patients presented with the complaint of CPP. After history, physical examination, routine investigations and USG, 79 cases were subjected to laparoscopy.
Results: Sensitivity and specificity of USG was found to be 69.56% and 100% respectively while for laparoscopy it was 98.46% and 100% respectively. Positive predictive value was 100% by both means but negative predictive value was significantly higher by laparoscopy i.e. 93.75% in marked contrast to USG (34.8%).
Conclusion: Laparoscopy triumphs in detecting many abnormalities which clinical methods and USG sometimes fail to identify. This enforces the position of laparoscopy as a gold standard in the evaluation of CPP.
