Study of duration of gestation in 500 patients with spontaneous onset of labor

Background: There have been variations in the length of gestation depending upon the ethnicity of the patient.Methods: We studied 500 patients with spontaneous onset of labor for their duration of pregnancy from First day of Last Menstrual Period (FLMP).Results: The average gestational age was 275 days, 5 days earlier than the Expected date of delivery (EDD). 70% of pregnancies ended before EDD, 4.8% on the day of EDD and 25.2% ended after EDD. 35.80% patients completed 39 weeks, 24% completed 40 weeks, 23.20% completed 38 weeks, 11% completed 37 weeks and only 6% completed 41 weeks. Average gestational age was 39.31 weeks for male baby and 39.36 weeks for female baby. Sex ratio derived was 915.7 females per 1000 males. Average birth weight was 2.705 kg.Conclusions: The implication of this study is that the length of human gestation does vary according to geographic location. This may be due to genetic influences, weather conditions, food habits or some unknown factor. The clinical significance is the decision to consider a term pregnancy and a post-term pregnancy. A majority of the parturient women went in to spontaneous labour at 39 completed weeks, 5 days earlier than ‘Expected date of delivery’ calculated by Naegele’s formula. This possibility should be kept in mind when maturity assessments are made with a view to intervene in the labour process to minimize perinatal complications

Analytical study of indications of cesarean section

Background: There has been an increase in rate of cesarean section over last few decades. There are various factors involved in the rise of rate of cesarean section. There has been an increase in primary cesarean section rate, a decrease in VBAC (Vaginal birth after cesarean section) trial, decrease in operative vaginal deliveries (Forceps/Ventouse), increase in litigations, increasing facility of electronic monitoring, and decreasing threshold of patients for bearing labor pains.Methods: A retrospective study was carried out in 500 patients in the tertiary care hospital). The data were collected in a pre-designed proforma. Data were analysed by using SPSS version 20.0 Software. We have done a retrospective study of different indications of cesarean section amongst 500 patients who underwent cesarean section from March 2015 to June 2015.Results: In our study, we found out that the most common indication was Previous cesarean section (46.2%), followed by Fetal Distress (13.4%) and malpresentations (11.4%). Non progress of labour (10.2%) and toxaemia of pregnancy (6.6%) were amongst the other indications.Conclusions: Reduction of number of primary cesarean sections and successful VBAC trials are recommended to keep the rate of cesarean sections to the possible minimum level

Role of methotrexate in ectopic pregnancy

Background: Ectopic pregnancy is an acute emergency in obstetric if not timely diagnosed and timely treated. Ectopic pregnancy is leading cause of death in first trimester. Ectopic pregnancy can be managed surgically or medically. Medical management with Methotrexate administration avoids anesthesia in surgery, is cost effective and also offers success rate comparable to surgical management. Aim and objectives were to study the role of methotrexate in ectopic pregnancyMethods: This will be a retrospective observational study conducted in Obstetrics and Gynecology department of AMC MET medical college. Study group constitutes of 30 females with ectopic pregnancy. Preliminary blood investigations, ultrasonography and beta-human chorionic gonadotropin (b-hcg) level will be tested. Patients will be treated with single dose of methotrexate 50 mg/M2. Follow up b-hcg level will be done after 48 hours. Response and tolerance to methotrexate will be monitored.Results: The success rate of methotrexate therapy in our study was 83.33% (n=25) and 16.66% (n=5) required surgical intervention with tubal ruptured and abdominal pain.Conclusions: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. It has the advantage of tubal conservation and saves patients from surgical intervention

Study of feto-maternal outcome in patients with hepatitis E infection during pregnancy

Background: Hepatitis E is considered as a common cause of high maternal morbidity and mortality particularly in third trimester and also high perinatal morbidity and mortality. Thus, this study is conducted to evaluate the feto-maternal outcome in patients infected with hepatitis E during pregnancy.Methods: It is a retrospective observational study conducted in department of obstetrics and gynecology at L. G. hospital. Fifty pregnant women with clinical hepatitis in third trimester of pregnancy were included in this study and thorough investigation were carried out. Patients were monitored till postpartum period and fetal monitoring data were collected from neonatal ICU.Results: In this study, majority of pregnant patients with hepatitis B were admitted during monsoon season suggests that HEV outbreaks are more common during monsoon months. Majority of the patients (70%) were emergency cases. Majority of these patients (82%) were belonged to lower socio-economic class. Co-infection with HAV was in 2% and with HBV in 4%. S. bilirubin >15 mg/dl in 16% of patients. PT and APTT were raised in 28% of patients. FDP was raised in 70% of patients. 76% were delivered vaginally and 22% were delivered by LSCS. Most common complication in HEV infected pregnant women was disseminated intravascular coagulation (DIC) (26%). Maternal mortality rate is 14%. Out of 50 patients, 88% delivered live baby, out of which 72% needed NICU admission. Perinatal mortality rate was as high as 28%.Conclusions: Hepatitis E infection and pregnancy is a deadly and fatal combination. Specifically, in 3rd trimester of pregnancy, acute hepatitis E has a grave prognosis with high maternal morbidity and mortality. Prevention is the mainstay of controlling HEV especially in developing countries

An analytical study of abnormal uterine bleeding in women of child bearing age group

Background: AUB (abnormal uterine bleeding) is defined as any variation from the normal menstrual cycle including alteration in its frequency, regularity of menses, duration of flow and amount of blood loss. In India, the reported prevalence of AUB is 17.9%. It can occur any time between menarche to menopause. A good clinician tries to recognize and identify the causative factors responsible for the disease, reverse the abnormality and induce or restore the cyclic predictable menses which should have normal volume and duration.Methods: 200 cases of AUB fitting the selection criteria were taken from OPD and gynecology ward between September 2020 to June 2021.Results: AUB was more common in the age group 41-45 years, that is, perimenopausal age group, more in multiparous women and women with previous surgeries on uterus and adnexa. Heavy menstrual bleeding was the most common complaint. Endometrial hyperplasia was the most common finding on ultrasound examination. Medical therapy was beneficial in some patients, rest had to undergo surgical intervention later.Conclusions: Transvaginal sonography is very accurate in assessing the endometrium as well as uterus and adnexa and diagnosing their abnormalities. Medical therapy is the first line of management in most cases. Dilatation and curettage should be used along with hysteroscopy for better results. LNG-IUS gives very good result in suitable cases. Hysterectomy is the final measure if everything else fails. Vaginal hysterectomy is preferred wherever possible

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

International audienceIn 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field