Impact of oligohydramnios on maternal and perinatal outcome: a comparative study

Background: Oligohydramnios has got significant impact on perinatal outcome and maternal morbidity. Therefore, early detection and its management will help in reduction of perinatal morbidity and mortality, decreased operative interventions. Hence, the present study is undertaken to study the impact of oligohydromnios on perinatal-maternal outcome.Methods: The present study was prospective comparative observational study conducted in the Department of Obstetrics and Gynaecology, Mallareddy Narayana Multispecialty Hospital, reputed teaching hospital from January 2015 to August 2017. The women were divided into study and control groups based on AFI, 100 cases were selected in each group.Results: Out of the 200 women, included in the present study, in study group AFI <5 cm was present in 51% of patients and AFI 5-8 cm in 49% of patients. Doppler abnormalities found in study group (n = 33). 32% of the patients in study group had non-reactive NST while in control group 8%. Caesarean section was performed in 70% of cases in study group as compared to 9% in control group. Foetal distress was the most common indication for LSCS. There were no perinatal deaths in this study.Conclusions: In this study amniotic fluid index of ≤5 cm was commonly associated with increased cesarean section rates, intrauterine growth restriction, Non-reactive NST and abnormal umbilical artery Doppler velocimetry studies. Hence, every case of oligohydramnios needs to be evaluated carefully, early detection and initiation of appropriate treatment and treat the cause if possible

Abnormal uterine bleeding in perimenopausal age group women: a study on clinicopathological evaluation and management

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management.

Impact of dietary and lifestyle choices on menstrual patterns in medical students

Background: The aim of the study was to evaluate average age of menarche, the pattern and types of menstrual disorders and their relation with BMI, dietary habits, physical exercise and stress.Methods: A cross sectional prospective study was conducted on female medical students during the academic year 2018-2019 at Mallareddy medical college for women, Suraram, Hyderabad, India. The various life style factors including BMI, junk food consumption and physical exercise were factored. Prevalence of each different menstrual abnormality were identified and analyzed by Chi-squire test and p value <0.005 was considered as statistically significant.Results: Study included 255 medical students who had attained menarche without known medical problems. Mean age of menarche was 12.81years. The most frequent menstrual disorders were premenstrual syndrome 192 (75 %), dysmenorrhoea 146 (57 %), and irregular cycle 97(38%). Statistically significant association of Body mass index (BMI) related to premenstrual syndrome (PMS) and dysmenorrhoea was reported (both p<0.05). Similarly, statistically significant association of lack of physical activity had greater risk of premenstrual syndrome and dysmenorrhoea (both p<0.0001). Unhealthy dietary patterns had statistically significant higher risk for dysmenorrhoea (p<0.0001).Conclusions: In conclusion premenstrual symptoms, dysmenorrhoea and menstrual irregularities were more prevalent. Majority of symptoms were stress, pain abdomen, irritability, mood swings. Comprehensive education programs on lifestyle modifications like regular physical activities, promoting healthy eating habits should be emphasised to prevent menstrual abnormalities of young students as early as at school level

Incidence of Incidental Finding of Mullerian Anomalies at Successful Term Pregnancies: A Three-Year Study in India

Introduction: Mullerian Anomalies are known to disturb the reproductive life of women immensely and adversely affect their obstetric outcomes too. Therefore, they get identified either during pubertal, early reproductive or antenatal period. Ultrasound diagnosis in pregnancy after first trimester is also very difficult Very few anomalies get diagnosed after a successful term pregnancy incidentally during delivery. Their actual incidence varies from 1-10% but little is known about incidence of unidentified cases in successful term pregnancies Aim: To determine the incidence of incidental finding of Mullerian Anomalies in successful term pregnanciesMethods: Over 3 year study period at a tertiary care centre we observed all women who delivered both by vaginal route and cesarean section for any Mullerian Anomaly. Results: Of the total 5124 women who delivered at our institute at term gestation, 3 women were excluded, as they were known cases of Mullerian anomalies on regular follow up at our institute. 11 women were identified with Mullerian Anomalies incidentally during delivery at term.9 of them were referral cases. 5 cases of Arcuate Uterus, 2 cases of septate uterus, 2 cases of Unicornuate uterus, 1 case of bicornuate uterus and 1case of agenesis of fallopian tube were found.Conclusion: Mullerian Anomalies are seen occasionally incidentally in successful term pregnancies during delivery. They can be asymptomatic, silent and can have positive pregnancy outcomes. These incidences are crucial for counseling of patients and their families. Also, we must be on a look out for these diagnoses not only to identify co existing urological disturbances but also to help us improve their subsequent obstetric performances

Abnormal uterine bleeding in perimenopausal age group women: a study on clinicopathological evaluation and management

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management.