A study of fetomaternal outcome in induction of labour in third trimester oligohydramnios

Background: The Induction of labor in oligohydramnios poses a dilemma for obstetrician. Studies are limited with variable results. This study aims at finding whether isolated oligohydramnios is an indication for operative delivery or labor induction followed by vaginal delivery is possible.Methods: A prospective study carried out on females delivered in study duration in Umaid Hospital, Jodhpur, Rajasthan. Outcomes studied were gestational age at delivery, colour of amniotic fluid, FHR tracings, mode of delivery, indication for cesarean section or instrumental delivery, Apgar score at one minute and five minutes, birth weight, admission to Neonatal Intensive Care Unit (NICU), perinatal morbidity and perinatal mortality. Descriptive statistics were applied and data was represented on frequency tables, graphs and diagrams.Results: 40% of subjects had amniotic fluid index (AFI) <5 cm and 60% demonstrated AFI between 5-7 cm. 60% of patients induced delivered vaginally with (38.33%) having AFI <5 cm. Operative delivery was resorted to in 40% of patients. Perinatal outcomes resulted in total 97% of babies discharged in healthy condition.Conclusions: Labor induction is feasible in idiopathic oligohydramnios. Fetal distress is the most feared and predicted outcome with labor induction in oligohydramnios. This study deduced that in majority- reason for c-sections was failed labor induction due the poor Bishop's score, not fetal reasons. We hope by putting at rest apprehensions of obstetrician regarding this notion rate of c-sections could be reduced

Misdiagnosis of interstitial pregnancy followed by circlage operation and failed induced midtrimester abortion: a case report

Interstitial pregnancy is rare form of ectopic pregnancy that can expand up to 18 weeks leads to massive haemoperitoneum hence early diagnosis is imperative to decrease mortality and morbidity. Present case diagnosed as interstitial pregnancy at laparotomy when she had taken for hysterotomy after two failed courses of medical abortion. Clinicians should bear in mind the limitations of various investigations and should have a higher degree of suspicion for interstitial pregnancy Any deviation from normal response to administration of medical abortificient, such as failure to abort, should instigate the diagnosis of ectopic (interstitial) pregnancy by expert radiologist

A Survey of Growth and Development Issues of the Pacific Islands

This paper is a survey of some key variables with an international dimension and implications for growth and development policies in selected Pacific island countries. Results from a simple growth accounting exercise show that factor accumulation is the most dominant growth factor and that the contribution of total factor productivity is negligible. Therefore, increasing the investment rate to improve growth rate is a pragmatic medium-term policy option. Further, econometric analysis shows that foreign aid has a negligible effect on output and growth in Fiji, Solomon Islands and Papua New Guinea.macroeconomic analyses, economic growth, development issues, Pacific islands

Protective effect of Trigonella foenum-graecum and Cinnamomum zeylanicum against diabetes induced oxidative DNA damage in rats

15-26Diabetes mellitus has become a global epidemic as its prevalence is steadily increasing everywhere at an alarming rate, most markedly in the India. Traditional Indian system of medicine based on herbal therapies is being practiced since ancient times and has been proved very effective against number of diseases. Trigonella foenum-graecum (Tfg) and Cinnamomum zeylanicum (Cz), the two spices, possess multiple medicinal properties. Hence present study is aimed to evaluate the protective effects of these plants on the oxidative DNA damage in diabetic rats. The presence of DNA base oxidation was investigated by modified comet assay which uses bacterial repair enzymes, formamidopyrimidine glycosylase and Endonuclease III which can measure oxidatively damaged purines and pyrimidines, respectively. Diabetes induced alteration in total antioxidant capacity (TAC), generation of superoxide anion and the levels of GSH, GSSG, NADH, NAD+, NADPH and NADP+ were monitored. Diabetes was induced by intravenous injection of alloxan, followed by oral administration of aqueous suspension of Tfg seeds and bark of Cz. Treatment of Tfg and Cz significantly restored the altered level of superoxide anion, TAC, ratios of GSH/GSSG, NAD(P)H/NAD(P)+ and NADH/NAD+ in the diabetic group. Furthermore, both the treatment effectively decreased the level of oxidatively damaged purine and pyrimidine bases

Ectopic pregnancy: an observational study in a tertiary care centre of Southern Rajasthan, India

Background: One among the three chief obstetric causes of bleeding in first trimester, ectopic pregnancy is the first thing to rule out as a gestation is suspected. The present study observes and analyses sociodemographic distribution, risk factors, presentation, diagnosis and treatment modalities in a tertiary care centre.Methods: An observational cross-sectional study, conducted among patients who were diagnosed and managed in department of obstetrics and gynaecology of a tertiary care centre. Data analyzed and explained as frequency, percentage, mean and standard deviation.Results: Age group between 21 to 30 years (69.9%) and multigravida (68.5%) are high risk for ectopic pregnancy (EP). Menstrual history was regular in 86.3%. Risk factors identified were previous abortion (30%) and history of pelvic inflammatory disease (30%). In 80.9% pain in abdomen was presenting complaints followed by bleeding per vaginum (60%), amenorrhoea (60%) and nausea and vomiting (32.9%). Right salpingectomy was most common in 43.8%, followed by left salpingectomy in 28.8%, methotrexate in 15.1%, left salpingo-ophorectomy in 5.5%, right salpingo-opherectomy in 5.5% and removal of tubal abortion in 1.3% patients. Laparoscopy was chosen route in majority 64.4% patients.Conclusions: Ectopic pregnancy - a gynecological catastrophe as well as a major challenge to the reproductive performance of women worldwide, should be considered a relevant public health issue. By providing adequate materials, manpower, well-equipped health facilities as well as a prompt and efficient referral system, good access roads and efficient transportation, will ensure early presentation in hospitals and prompt management of cases

Protective effect of Trigonella foenum-graecum and Cinnamomum zeylanicum against diabetes induced oxidative DNA damage in rats

Diabetes mellitus has become a global epidemic as its prevalence is steadily increasing everywhere at an alarming rate, most markedly in the India. Traditional Indian system of medicine based on herbal therapies is being practiced since ancient times and has been proved very effective against number of diseases. Trigonella foenum-graecum (Tfg) and Cinnamomum zeylanicum (Cz), the two spices, possess multiple medicinal properties. Hence present study is aimed to evaluate the protective effects of these plants on the oxidative DNA damage in diabetic rats. The presence of DNA base oxidation was investigated by modified comet assay which uses bacterial repair enzymes, formamidopyrimidine glycosylase and Endonuclease III which can measure oxidatively damaged purines and pyrimidines, respectively. Diabetes induced alteration in total antioxidant capacity (TAC), generation of superoxide anion and the levels of GSH, GSSG, NADH, NAD+, NADPH and NADP+ were monitored. Diabetes was induced by intravenous injection of alloxan, followed by oral administration of aqueous suspension of Tfg seeds and bark of Cz. Treatment of Tfg and Cz significantly restored the altered level of superoxide anion, TAC, ratios of GSH/GSSG, NAD(P)H/NAD(P)+ and NADH/NAD+ in the diabetic group. Furthermore, both the treatment effectively decreased the level of oxidatively damaged purine and pyrimidine bases

Repeated broad ligament hematomas managed by uterine artery embolization: time to execute

Selective arterial embolization (SAE) of the uterine arteries is an alternative to surgery when medical management fails in cases of intractable posrtpartum haemorrhage. It is highly efficacious with low complication rate. Here we report a case of repeated broad ligament haematoma managed by selective uterine artery embolization. Present case 28year old P4L4 was referred from a district hospital as post LSCS case with broad ligament haematoma. Patients general condition was very poor at the time of admission. She underwent laparotomy twice and finally uterine artery embolization for repeated broad ligament haematoma and responded. Massive obstetric haemorrhage remains a significant cause of maternal morbidity and mortality. The threshold for uterine artery embolization (UAE) in women with obstetric haemorrhage should be low, as it is coupled with a high clinical effectiveness rate, low complication rate and preservation of fertility. However, it requires an infrastructure, multidisciplinary approach, as well as speedy and effective interaction between various specialties

Effect of COVID-19 on Menstruation: An Observational Study

Introduction: COVID-19 patients have been reported to have systemic complications. Analyzing its effect on the endocrine system is essential to ensure women’s reproductive health. Aim: This study aimed to determine the effect of COVID-19 disease on menstruation. Methods: It was a hospital-based cross-sectional study conducted from October 2021 to April 2022, using a validated questionnaire to collect the data. The study included females (15 to 49 years) who had confirmed COVID infection. Results: A total of 132 females participated in the study. For 29 (22%) patients presenting with menstrual cycle changes, most common change was prolonged cycle (14%). An increase in menstrual volume was reported by 12%, where as 35% of patients experienced more pain during menstruation. Menstrual irregularities were significantly higher in severe infection (p-value 0.04). Conclusion: There were transient changes in menstruation in COVID-19-infected patients, with a higher probability of menstruation abnormalities among severely infected patients

Implications of socio-economic factors on contraceptive choices among women in North East India: a perspective

Background: Socio economic status plays a vital role in determining the awareness and conscious decision making of a woman pertaining to contraceptive use. Family planning has been recognized as one of the most cost-effective solutions for achieving gender equality and equity by empowering women with knowledge and in making reproductive choices by accessing contraceptive methods. Methods: A cross sectional study was conducted on 1000 married women of reproductive age group in the Department of Obstetrics and Gynaecology, NEIGRIHMS, Shillong, Meghalaya, from April 2021 to April 2022. NEIGRIHMS being a tertiary referral centre caters to patients from the entire North Eastern Region of India. A validated questionnaire was used for sociodemographic information, knowledge, awareness and attitude towards different contraceptive methods. Results: Out of 1000 married women, 82.5% women were aware about contraceptive methods, 67.5% women had knowledge on the different types of contraceptive methods available and only 370 (37.04%) of the participants are using at least one type of contraceptive methods and of these, 280 (28%) women preferred condom. Bivariate analysis revealed that factors such as current age, economic status and occupation, were seen to influence the utilization of contraceptive methods among women. Conclusions: While it is noteworthy to see the efforts made by the Government towards achieving the various health targets but sincerer and dedicated efforts are needed to ensure increased awareness about the importance of family planning

Study of fetomaternal outcomes in antepartum haemorrhage at tertiary care centre

Background: Antepartum haemorrhage (APH) is a challenge to obstetrician as it involves a question of life and death to mother and fetus. Antepartum hemorrhage is the 2nd most common cause of maternal mortality and morbidity as sepsis and obstructed labour has decreased now. The aim of the study is to find the prevalence of APH. And to study foeto-maternal outcomes in patients with antepartum haemorrhage, association of comorbidities and risk factors.Methods: This study was conducted at Geetanjali Medical College and Hospital, Udaipur after obtaining approval from institutional research ethical board and written informed consent during the period of February 2019 to July 2020. This was prospective observational study, sample size was 60 patients. All the APH patients who were admitted at GMCH Obstetrics and Gynaecology department after 28 weeks of gestation were included in study. Extrauterine or bleeding due to general pathology was excluded. Total number of delivery were 1900 in above duration and number of APH patients were 60, so our incidence is 3.1%.Results: Total number of delivery were 1900 in above duration and number of APH patients were 60, so our incidence is 3.1%. According to maternal complications rate, It was 66.66 % in abruptio placenta, 37.03 % in placenta previa and jointly 53.33%. In placenta previa group 100% patients discharged with good GC, In abruptio placenta group 96.96% patients discharged with good GC and 3.04% patients discharged with poor GC. Perinatal mortality was zero in placenta previa group and in abruptio placenta, it was 27.27% (24.24% IUD, 3.03% neonatal death).Conclusions: The main cause of APH was abruption which was seen in 33 (55%) of patients and placenta previa was seen in 27 (45%) of patients. Maternal and neonatal complications, both were very high in abruption group as compared to placenta previa group. Overall maternal mortality rate was 53.33% and perinatal mortality rate was zero in placenta previa group while in abruption placenta group, it was 27.27%. There was no maternal complications in booked placenta previa cases only there were very few complications in emergency cases. In abruptio placenta group also complications were more in emergency cases, irregular booked and uncontrolled pregnancy pathology cases.