Decidual cast

Decidual cast describes the spontaneous sloughing of endometrium as an entire piece while retaining the shape of endometrial cavity. 15 year old girl presented to the outpatient Department of Obstetrics and Gynaecology, Subharti medical college in September 2015 with complaints of heavy menstrual bleeding since the onset of menstruation. On examination her vitals were stable and there was mild pallor. Systemic examination was found to be normal. All her investigations were within normal limits. She was give iron supplementation and was started on low dose combined oral contraceptive pills. Every woman should obtain detailed information about the possible side effects of hormonal therapies including endometrial cast discharge

Predictive value of admission and intrapartum cardiotocography in normal and high risk antenatal women

Background: Cardiotocography is the most common method for assessing fetal health and reveals brain oxygenation. This study is done for admission and intrapartum cardiotocography in high- and low-risk pregnancies and its correlation with neonatal outcome. Methods: All high-risk and normal antenatal women with more than 34 weeks of pregnancy and vertex presentation who came to the labor room were included in the study. 200 cases were taken, 100 were in the "high risk group," and the remaining 100 were in the "low risk group." On admission CTG and intrapartum CTG tracing were taken after written and informed consent, neonatal outcomes were observed, and adverse neonatal outcomes were noted. Results: Admission CTG results were unsatisfactory for 9% of women in the high-risk group and none in the low-risk group. Intrapartum NST was non reassuring in 51% of high-risk women and 6% of the low-risk group. Of the total number of neonates admitted to the NICU, 14 were from the low-risk group, while 50 were from the high-risk group. Conclusions: On admission NST in both low and high-risk women, the absence of category III NST predicted the absence of an adverse neonatal outcome most accurately. Even during labor in both high-risk and low-risk women, the absence of category III reassured the fetal well-being most precisely

Colposcopic evaluation in cases of persistent inflammatory Pap smear

Background: The aim of the study was to assess the colposcopic evaluation in cases of persistant inflammatory Papanicolaou (Pap) smear.Methods: This was a prospective analytical study, conducted amongst 78 women attending the outpatient department of obstetrics and gynaecology at Subharti Medical College. Pap smear was performed by the conventional method and colposcopy was done for all 78 sexually active women who came with complaints of pain abdomen, irregular cycles, white discharge per vaginum and urinary tract infections. Final correlation of Pap smear and colposcopy were based on histopathology and human papillomavirus deoxyribonucleic acid (HPV DNA).Results: In this study of 78 women, 21% of women had normal colposcopic findings whereas 79% had abnormal colposcopic findings. Histopathological examination (HPE) findings revealed that 69% women had cervical intraepithelial neoplasia (CIN) 1, 23% had CIN II, 6% had CIN III and 3% had SCC. 25% women tested positive for HPV DNA and 75% women tested negative for HPV DNA.Conclusions: Patients with persistent inflammatory Pap smear despite undergoing treatment show changes on Colposcopic directed biopsies.

Anemia and its effect on thyroid profile in pregnant women in tertiary care centre

Background: According to WHO, highest incidence of anaemia is seen in Asia with about half of the anaemic women present in Indian subcontinent only. Various studies in the past have reported that iron deficiency hampers thyroid function. The thyroid hormones are essential for both foetal and maternal well-being. Our aim was to study anemia among pregnant women and its effect on thyroid profile. Methods: In this prospective observational cohort study 200 women were enrolled (100 anemic and 100 non anemic) and subsequent thyroid profile was done. Confounders like high risk pregnancy, chronic diseases like coronary heart disease, renal failure/insufficiency, liver disease, Astro-intestinal diseases, known cases hypothyroidism was excluded. The women were followed up till delivery. The data was be tabulated and analysed using Chi square test in case of qualitative data and student t test in case normally distributed quantitative data. Results: Four percentages of pregnant women had overt hypothyroidism in anemic group as compared to 3% in non-anemic group. 35% in anemic group had sub-clinical hypothyroidism as compared to 16% in non-anemic group and the difference was statistically significant. The comparison of TSH values in anemic and non anemic women was statistically significant (p=0.002). There was no association found with severity of anemia with TSH, ft3, ft4 values. Conclusions: The present study found a significant association between anemia and hypothyroidism. However thyroid dysfunction was not associated with the severity of anemia. Further studies are warranted to directly identify the causal relationship between the two

Comparative study of hysteroscopy, hysterosalpingography and transvaginal sonography in evaluation of the female infertility

Background: One of the most important and underappreciated reproductive health problems in developing countries is that of infertility. Objective of this study was to evaluate HSC (hysteroscopy), HSG (hysterosalpingography) and ultrasonography in infertility.Methods: This study was conducted among 100 infertile patients over a period of two years. The patients were questioned for the detailed history including socioeconomic status, medical history and previous history of taking any medications and supplements. The recruited patients had to undergo.Results: Transvaginal sonography and clinical examination were done. Transvaginal sonography detected abnormality in 40% of women. 65 women had normal hysterosalpingography findings whereas the rest 35 women had abnormal hysterosalpingography findings. Thirty nine percent (39%) had normal hysteroscopic findings while sixty one percent (61%) had abnormal findings. The study depicts that hysteroscopy has sensitivity (95%) and negative predictive value NPV (92%) whereas that of TVS is 48.9% and 44.9% respectively. Hysterosalpingography has sensitivity 68.3% and NPV 40.3%. Specificity (100%) and positive predictive value PPV (100%) of all the three modalities are the same.Conclusions: The results of the present study showed that each modality provided useful information but no single modality provided complete information for evaluating infertile women. Thus, a combination of all three modalities- TVS (transvaginal sonography), HSG (hysterosalpingography) and hysteroscopy is necessary to evaluate infertile women

Comparison of ease of insertion, visibility of strings and continuation rate of post-partum intrauterine copper device insertion by long inserter versus with the help of Kelly’s forceps

Background: The objective of the study was to compare ease of insertion, visibility of strings and continuation rate of post-partum intrauterine copper devices (PPIUCD) insertion by long inserter versus with the help of Kelly’s forceps.Methods: 100 women were enrolled in our study which was conducted in department of obstetrics and gynecology, Subharti medical college and Chattrapati Shivaji Subharti hospital (CSSH), Meerut over a period of 2 years between November 2018 and August 2020. In study comparison was done on insertion technique of PPIUCD.Results: High fundal placement was achieved with long inserter. There was no perforation and decreased infection rate among the users with no increase in incidence of side effects and expulsion. Among 50 insertion, 1 woman (2%) had partial expulsion, 2 women (4%) had complete expulsion and 1 woman (2%) got PPIUCD removed on request. Providers reported 100% easier technique. 96% satisfaction among the users.Conclusions: The dedicated long inserter PPIUCD was found to be safe, with high acceptability among the participants and providers. Study revealed the reduced risk of infection and expulsion, providers also reported increased convenience in insertion compared to standard PPIUCD insertion techniques