Role of diagnostic laparoscopy in infertility

Background: Use of diagnostic and therapeutic laparoscopy in infertility has been a focus of attention in recent years and demonstrated to be very effective method in evaluating these cases. The main objective of the study was to detect the diagnostic efficacy of laparoscopy in uterine, pelvic and ovarian pathologies.Methods: This prospective study included 50 infertile women and it was conducted at department of Obstetrics and Gynaecology, Smt. N.H.L. Municipal Medical College, Ellisbridge, Ahmedabad during the period between May 2006 to November 2008. After thorough gynecological examination, necessary investigations were made and written consent form was taken from them before laparoscopy. The patients were kept fasting for 24 hours before the laparoscopy and the procedure was performed under general anaesthesia. All the data was collected on pre-designed proforma and the results were tabulated and raw percentages calculated to describe the results.Results: Among 50 patients, 34 were of primary infertility cases and 16 were of secondary infertility. In primary infertility maximum number of patient belonged to age group of 21-25 years where as secondary infertility were under the age group 26 – 30 years and above 31 years of age. In primary infertility 65% patients had active marriage life duration of 2 – 4 years, while in secondary infertility cases 81% of patients had marriage life age of more than 6 years. Out of 50 patients, 14 (28%) had absolutely normal laparoscopic findings. Among the various pathologies observed, ovarian pathology contributed the most (36%), followed by tubal (26%), pelvic (22%) and uterine (10%) pathologies.Conclusions: Laparoscopy is safe and cost effective method and should be considered as prime diagnostic tool for evaluating the etiology of infertility in women and for effective treatment decisions

A study of maternal and perinatal outcome in patients of postpartum hemorrhage in a tertiary care hospital, Gujarat

Background: Postpartum hemorrhage (PPH) is significant factor for maternal mortality. Prevalence of PPH is 6.0% worldwide and highest prevalence was noted in Africa which is almost 10.1%. In India, maternal hemorrhage is the very common factor for maternal mortality. The objective of the study was to understand incidence of PPH and various risk factors for it, to study maternal morbidity and mortality associated with PPH and to study the effective mode of management in PPH.Methods: This prospective study was done among 50 cases of postpartum haemorrhage out of 13,628 deliveries at civil hospital, Asarwa, Ahmedabad during November 2008 to October 2010 and analysis was done regarding patients’ socio demographic characteristics, various risk factors, causes and maternal and perinatal outcome.Results: Incidence of PPH was 0.36%. Almost >85% cases were belonged to 20-34 years age group. Highest cases (38%) seen in primigravida and 72% cases have normal vaginal delivery. Anemia noted in highest cases (22%) and 68% cases have most common etiology was atonicity. Birth weight <2.5 kg found in 36% cases. Most common maternal outcome was fever (16%) and 72% cases delivered healthy and alive birth.Conclusions: The patients were mostly primiparous. The commonest associated medical condition was anemia. The commonest underlying cause of PPH was atonicity of the uterus. Commonest maternal outcome was fever. Out of total births, 72.0% were alive and healthy babies followed by 18.0% babies were still birth

Role of diagnostic laparoscopy in infertility

Background: Use of diagnostic and therapeutic laparoscopy in infertility has been a focus of attention in recent years and demonstrated to be very effective method in evaluating these cases. The main objective of the study was to detect the diagnostic efficacy of laparoscopy in uterine, pelvic and ovarian pathologies.Methods: This prospective study included 50 infertile women and it was conducted at department of Obstetrics and Gynaecology, Smt. N.H.L. Municipal Medical College, Ellisbridge, Ahmedabad during the period between May 2006 to November 2008. After thorough gynecological examination, necessary investigations were made and written consent form was taken from them before laparoscopy. The patients were kept fasting for 24 hours before the laparoscopy and the procedure was performed under general anaesthesia. All the data was collected on pre-designed proforma and the results were tabulated and raw percentages calculated to describe the results.Results: Among 50 patients, 34 were of primary infertility cases and 16 were of secondary infertility. In primary infertility maximum number of patient belonged to age group of 21-25 years where as secondary infertility were under the age group 26 – 30 years and above 31 years of age. In primary infertility 65% patients had active marriage life duration of 2 – 4 years, while in secondary infertility cases 81% of patients had marriage life age of more than 6 years. Out of 50 patients, 14 (28%) had absolutely normal laparoscopic findings. Among the various pathologies observed, ovarian pathology contributed the most (36%), followed by tubal (26%), pelvic (22%) and uterine (10%) pathologies.Conclusions: Laparoscopy is safe and cost effective method and should be considered as prime diagnostic tool for evaluating the etiology of infertility in women and for effective treatment decisions