A retrospective study on ectopic pregnancy aspiration by transvaginal ultrasound at Institute of Kidney Diseases And Research Centre

Background: Majority of the reports suggest that the frequency of ectopic pregnancies have grown in the last 30 years, especially in patients conceived through artificial reproductive techniques (ART). To prevent severe morbidity and mortality its prompt diagnosis and appropriate management is important. In a select patient population, most of the unruptured, live ectopic pregnancies can be successfully managed without surgical intervention using trans-vaginal ultrasound guided aspiration and instillation of local injection KCl or administration of systemic Inj. Methotrexate. Methods: This study is a hospital based retrospective cohort study from January 2014 to December 2022 on patients who presented to Institute of Kidney Diseases and Research Centre (IKDRC) with unruptured ectopic pregnancy confirmed with ultrasound and β HCG. All the patients were analyzed according to history, clinical presentation, investigations, treatment and complications. Results: β-HCG day 1 or 2 post procedure dropped in all cases but in variable levels ranging from 1.3% to 85.88%, while the drop during days 7-10, was more significant and reassuring; ranged from 48.69% to 98.95%. Conclusions: By aspiration of ectopic gestational sac transvaginally under ultrasonographic guidance it is able to preserve the integrity of uterus and fallopian tube and thus the future fertility. The study will educate other healthcare professionals.

A successful pregnancy outcome after mitral valve replacement: a case report

Valvular heart disease can be acquired or congenital. Although the incidence of rheumatic heart disease is on the decline, the number of patients with congenital heart disease who survive into adulthood has grown substantially over the past 30 years. Therefore, a large number of patients with valvular heart disease will be of childbearing age. Here we presented a case of second gravida who was diagnosed with rheumatic heart disease and had undergone mitral valve prosthesis and tricuspid valve repair delivered a healthy live male baby weighing 2.250 kg

Role of cetrorelix in the prevention and treatment of ovarian hyperstimulation syndrome: a prospective case control study

Background: Ovarian hyperstimulation syndrome (OHSS) has intrigued clinicians for many years because of its devastating consequences. As an iatrogenic condition resulting from elective ovarian stimulation in the quest for pregnancy, the need to completely prevent the syndrome is evident. Gonadotropin releasing hormone (GnRH) antagonist Cetrorelix has found to be effective in treatment of OHSS and some studies have found it to be helpful in prevention of this condition. Hence, we designed a hospital-based study to investigate the effect of Cetrorelix in preventing and treating OHSS in in-vitro fertilization – embryo transfer (IVF–ET) patients at risk of OHSS undergoing long and short protocol. Methods: The study includes total 102 patients undergoing controlled ovarian stimulation COS for IVF/ICSI. All cases were stimulated using long and short protocol. Depending on whether a GnRH antagonist was given after ovum pick-up (OPU) the patients were divided in two groups: Cetrorelix (antagonist) group (n=51) and control group (n=51). The study group was treated with Cetrorelix 0.25 mg for 5 days commencing on the day of ovum pick up. Results: Incidence of mild OHSS was significantly higher (p=0.01) whereas moderate to severe OHSS was significantly lower in the antagonist group (p<0.05). None of the patients had critical OHSS. Conclusions: GnRH antagonist Cetrorelix administration in early luteal phase in patients undergoing long or short protocol is effective in prevention and treatment of OHSS

Incidence and prevalence of sexual dysfunction in infertile females

Objective: The sexual response in women is complex. The association of infertility and sexual dysfunction is overlapping. To find the incidence and prevalence of female sexual dysfunction in infertile females and its correlation with infertility. Design: Case-control study. Setting: G.R. Doshi and K.M. Mehta Institute of Kidney Diseases & Research Centre (IKDRC)- Dr. H.L. Trivedi Institute of Transplantation Sciences (ITS), India. Methods: Total of 500 patients in the age group of 24–42 years participated in the prospective study. They were assigned as fertile and infertile groups. Female sexual dysfunction was assessed according to FSFI questionnaire. Patients with past history of any psychiatric illness, endocrinological disorders e.g. diabetes mellitus or on antihypertensive treatment were excluded. Results: In our study 170 (63.67%) patients in the infertile group (n = 267) had female sexual dysfunction as compared to108 (46.35%) in the fertile group (n = 233), which is statistically significant (P 0.0001). Most common dysfunction observed was arousal (70%) in infertile patients. Common dysfunctions observed in fertile females were desire (40%) and orgasm (40%). FSD was significantly higher in infertile females of the 31–37 years age group (P 0.002), while more common in fertile females of >42 years of age (P < 0.0001). Higher female sexual dysfunction was observed in illiterate infertile females (P 0.039). Among the pathological factors endometriosis was the statistically significant factor associated with female sexual dysfunction and infertility (P < 0.0001). No significant correlation in duration of infertility or type of infertility was observed with female sexual dysfunction. Female sexual dysfunction as the cause or the effect should be ascertained in infertility