Role of vaginal progesterone in reducing the rate of preterm labour in women with a sonographic short cervix

Background: Preterm labour is responsible for not only neonatal morbidity and mortality but also has long term consequences .Till now there is no effective method of prevention. Progesterone has shown promising result. But ideal candidate, ideal route and when to start the treatment are still in dilemma. The present study was undertaken to know the role of progesterone on pregnant women with sonographically short cervix.Methods: This prospective case control study was started on 100 pregnant women with sonographic short cervix (≤2.5 cm) and between 19 – 29 weeks of gestation. 60 women, some with history of midtrimester abortion or preterm labour and some without this history were treated as cases and were given vaginal progesterone pessary 200 mg once daily till rupture of membrane or onset of labour or up to 36 weeks of gestation whichever is earlier. 40 women without any history of midtrimester abortion or preterm labour were treated as control and followed up.Results: Among the cases 18.3%, delivered preterm and 81.7% were term deliveries. Respective proportions among control were 40% and 60% respectively. 26 among the cases and all women of control group did not have history of preterm labour and mid trimester abortion. In the case group 26.9% and in the control group 40% had preterm deliveries. Though the proportion of labour was lower among the cases it is not statistically significant (p = 0.276). There is mean prolongation of gestational age by 8.4± 1.29 weeks in case group in present pregnancy compared the previous one in cases with history of preterm labour and midtrimester abortion which was statistically significant .When neonatal complication are compared there is no significant difference between the two groups.Conclusions: Vaginal progesterone started from midtrimester in pregnant ladies with short cervix with previous history of midtrimester abortion or preterm labour is effective in reducing the rate of preterm birth

Maternal and perinatal outcome of eclampsia in a tertiary care centre

Background: Eclampsia is associated with devastating maternal and fetal complications. The main objective was to study the perinatal and maternal outcome and the causative factors for the mortality and morbidity in eclampsia patients admitted to this hospital and to explore the factors contributing to the alarming situation.Methods: 218 eclampsia cases admitted to the labour room in Department of Obstetrics & Gynaecology, SCB Medical College Cuttack, Odisha, India from Jan 2013 to Sept 2014 enrolled for the study.Results: In this study 218 eclampsia cases were studied. The incidence of eclampsia in S.C.B.MCH during study period was 1.39%. Most of the patients were primigravida accounting 83.48% out of which 74.31% were antepartum, 14.22% were intrapartum and 11.47% were postpartum. 44.04% of cases had no ANC and 40.36 irregular ANC. Occurrence of onset of eclampsia at <34 weeks GA 27.53%, 35-37 weeks 43.12 % and >38 weeks 29.35%. Most of patients were from rural area (97.50%) and having low socioeconomic status (83.94%) and illiterate. Out of 218 cases 46.33% patients had vaginal delivery, 3.21% patients had vaginal delivery with instrumentation.Conclusions: There is a need of proper antenatal care to prevent eclampsia and the need for intensive monitoring of women with eclampsia throughout hospitalization to improve both the maternal and perinatal outcome

Ovarian hyperstimulation syndrome mimicking ovarian malignancy: a case report

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication. In most cases, the clinical manifestations of OHSS are self-limited and OHSS resolves spontaneously within a few days, provided that appropriate supportive measures are taken. However, OHSS has been associated with substantial morbidity, principally acute respiratory distress, and fatal complications have been reported in patients with severe or critical OHSS

Adnexal torsion in a heterotopic pregnancy: a rare clinical entity with diagnostic dilemma

Adnexal torsion is an uncommon cause of surgical emergency during pregnancy. Its incidence is 1 in 5000 pregnancies, occurring more frequently in the first trimester after ovarian hyper stimulation. Heterotopic pregnancy is also a rare entity and cause pain abdomen but without the classical symptom of bleeding per vaginum. Heterotopic pregnancy with adnexal torsion is extremely rare but increases the case fatality rate. Hence the differential diagnosis of pain abdomen during early pregnancy both may be considered and it should not be forgotten that adnexal torsion may occur in absence of ovarian cyst. We report a case of adnexal torsion that was successfully managed by laparoscopy followed by laparotomy during pregnancy and diagnosed as a heterotopic pregnancy after getting the histopathological report. A 24-year-old G2P1 admitted to LR of SCBMCH at 4 weeks of GA with severe left abdominal pain and nausea for one day. Her vitals were stable. There was tenderness on the left iliac fossa with cervical motion tenderness and left POD fullness and tenderness, TAS visualized a foetus in utero with GA of 7 weeks and a hyperechoic mass of 6 x 6 cm on left side. Laparotomy done as the mass was gangrenous, enlarged and haemorhagic. Total salpingo oophorectomy of left side was done. Postoperative period was uneventful and managed with progesterone to continue the pregnancy. Histopathology report confirmed heterotopic pregnancy. This case suggests that clinicians should suspect both heterotopic pregnancy and adnexal torsion while evaluating pregnant patients with pain abdomen

Thoracopagus conjoined twins: a case report

25 yr. old, G2P1 presented with premature labour pains at 33wks 3d of gestation and was referred to our tertiary centre as a suspected case of conjoined twin pregnancy based on a sonography report which revealed fetus with two heads Decision in favour of LSCS was taken after counselling the patient and her attendants regarding the anomaly of the fetus and incompatibility of life and dangers of spontaneous vaginal delivery. LSCS was done with delivery of first twin by cephalic and second twin by breech extraction, both were preterm male babies  joined anteriorly  starting from  thorax to umbilicus (Thoracopagus) with  four arms and four legs, baby could not be revived and was declared clinically dead in few minutes by neonatologist,. Photographs were taken and we tried to obtain consent for autopsy but attendants were reluctant. A review of the literature suggests that early diagnosis by a combination of ultrasound and MRI is essential to management, providing prognosis for viability and success of surgical separation and the opportunity for early counselling of parents and termination if indicated.

Investigation on structural, Mossbauer and ferroelectric properties of (1-​x)​PbFe0.5Nb0.5O3-​(x)​BiFeO3 solid solution

(1-​X)​PbFe0.5Nb0.5O3(PFN)​-​(x)​BiFeO3(BFO) multiferroic solid solns. with x = 0.0, 0.1, 0.2, 0.3 and 0.4 were synthesized through single step solid state reaction method and characterized thoroughly through x-​ray Diffraction (XRD)​, SEM, Fourier Transform Infra-​Red (FTIR)​, Raman, Mossbauer spectroscopy and ferroelec. studies. The room temp. (RT) XRD studies confirmed the formation of single phase with negligible amt. of secondary phases (x = 0.2 and 0.4)​. The zoomed XRD patterns of (1-​x)​PFN-​(x)​BFO solid solns. showed the clear structural phase transition from monoclinic (Cm) to rhombohedral (R3c) at x = 0.4. The Raman spectra of the (1-​x)​PFN-​(x)​BFO solid solns. showed the compn. dependent phase transition from monoclinic (Cm) to rhombohedral (R3c)​. With increasing x in PFN, the modes related monoclinic symmetry changes to those of rhombohedral symmetry. The RT Mossbauer spectroscopy results evidenced the existence of compn. dependent phase transition from paramagnetic to weak antiferromagnetic ordering and weak antiferromagnetic to antiferromagnetic ordering. The Mossbauer spectroscopy showed paramagnetic behavior with a doublet for x = 0.0, 0.1 and 0.2 are shows the weak antiferromagnetic with paramagnetic ordering. For x = 0.3 and 0.4 shows the sextet pattern and it is a clear evidence of antiferromagnetism. The ferroelec. (P-​E) loops at RT indicate small polarization, as the x concn. increases in PFN, the remnant polarization and coercive field were decreased, which may due to the increase in the cond. and leaky behavior of the samples

Pregnancy in two patients of Glanzmann’s thrombasthenia: a rare case report

Glanzmann’s thrombasthenia (GT) is inherited platelet disorder with an autosomal recessive mode of inheritance. Though, quantitatively normal, the aggregation ability of platelets is reduced in this condition. Pregnancy and delivery are rare in these patients and have been associated with a high risk of severe postpartum hemorrhage. We describe two GT here 1st case was a primigravida, who was diagnosed to have GT 11 yrs back and was admitted as a term pregnancy which was terminated by elective caesarean section and was was successfully managed by platelet transfusion. 2nd case was a 24 year old lady got diagnosed as GT during the evaluation of frequent mucocutaneous bleed. Her antenatal management was like that of normal pregnancy. She was hospitalized 6 weeks prior to expected date of delivery. Elective LSCS (Lower Segment Caesarean Section) was done and was managed with 4 units of single donor platelet (SDP) without any other complication