Evaluation of pain relief and satisfaction in women using epidural analgesia in labour

Background: Pain during childbirth is the most severe pain women may experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour.Methods: This retrospective study was carried out at Omega Hospital, Nagpur in 50 women in labour who demanded epidural analgesia for pain relief. It was carried out to determine extent of pain relief and overall satisfaction in women using epidural analgesia.Results: In present study, out of 50, 28 (56%) patients delivered by normal vaginal delivery, 14 (28%) patients delivered by cesarean section, 8 (16%) patients had vacuum delivery while in no patient forceps were applied. In first stage,36 (72%) patients had zero score (no pain), 13 (26%) patients had 1-3 score (mild pain) while 1 (2%) patient had 4-6 score (moderate pain) after epidural analgesia. That means epidural analgesia had very good effect in first stage in terms of pain scoring. In second stage, 13 (26%) patients had zero score (no pain), 31 (62%) had 1-3 score (mild pain) while 6 (12%) had 4-6 score (moderate pain) after epidural analgesia. That means epidural analgesia had good effect in second stage in terms of pain scoring. In terms of satisfaction, 11 (22%) patients said it was excellent, 27 (54%) patients said it was good, 8 (16%) patients said it was average while 4 (8%) said it was poor. Apgar score for all babies at 1 min and 5 min was very good. It was ≥7 in all 50 (100%) of newborn babies.Conclusions: Epidural labor analgesia gives significantly less pain scores and has better maternal satisfaction. It is not associated with increased rate of instrumental vaginal delivery or cesarean delivery. Patients had excellent neonatal outcome

Awareness of PCOS (polycystic ovarian syndrome) in adolescent and young girls

Background: Polycystic ovarian syndrome (PCOS) is an endocrine disorder which affects the adolescent girls It affects 5% to 10% of women in their reproductive age. Awareness and accurate diagnosis is the first step in managing PCOS as it improves quality of life of the patient. The study was conducted to assess the knowledge on PCOS among the medical students.Methods: Survey of 200 girls was done to assess the knowledge on the polycystic ovarian syndrome among the medical students of different colleges studying in 1st, 2nd, and 3rd year. The data was collected from the students by using structured questionnaire.Results: In present study, 51% girls had normal BMI, 19.5% were overweight, 16.5% were obese while 13% were underweight. 33.5% females had acne, 16% had irregularity of menses, 5% had hirsutism while 2% had infertility. In present study, 33% adolescent and young girls had information about PCOS from teacher, 19% got information from friend, 11.5% got information from a doctor, 3.5% got information from newspaper while 5% got information from internet. 28% adolescent and young girls were unaware of PCOS.Conclusions: Thorough knowledge of the disorder and counseling for adolescents should be included in the curriculum which will provide awareness towards the disorder and lifestyle modification. Accurate diagnosis at a younger age may be a key

Maternal body mass index: how much it affects mother and baby

Background: Overweight, obesity, and morbid obesity in the mother are associated with adverse obstetrics well as neonatal outcome. Aim of this study was to assess the prevalence of overweight and obesity, and the impact of body mass index (BMI) on maternal and neonatal outcome.Methods: This is a retrospective study from January 2018 to September 2018 on 180 women with singleton term pregnancies. Maternal and neonatal outcomes at delivery were noted.Results: In present study, 3 (1.66%) pregnant women were underweight, 57 (31.66%) pregnant women had normal BMI, 71 (39.44%) pregnant women were overweight while 49 (27.22%) pregnant women were obese. Gestational weight gain was less than 8 kgs in 40 (22.22%) pregnant women, weight gain was 8-15.9 kgs in 132 (73.33%) pregnant women while weight gain was more than 16 kgs in 8 (4.44%) pregnant women. Out of 3 underweight women, 1 delivered by cesarean section and 2 had normal delivery, out of 57 women with normal BMI, 21 delivered by cesarean section and 36 had normal delivery, out of 71 overweight women, 47 delivered by cesarean section and 34 had normal delivery while out of 49 obese women, 38 delivered by cesarean section and 11 had normal delivery. PET and GDM was seen in 9 (7.5%) women each while macrosomia were seen in 5 (4.16%) women.Conclusions: Increased association was seen with maternal obesity and adverse outcome of pregnancy like PIH, GDM, cesarean section

Preventive gynaecology: awareness, attitude and practices of gynecologists

Background: Gynecologists are aware of screening tests of all gynecological malignancies. However, attitude and practices do not match with this. Present study was conducted in 214 gynecologists to evaluate awareness, attitude and practices of preventive gynecology.Methods: A survey was conducted among 214 gynecologists of Nagpur, using a questionnaire. This evaluated implementation of screening and preventive measures used by them for self-protection as well as for the women seeking their services. Their attitude regarding HPV vaccine as a preventive measure was also noted.Results: In present study, 160 (74.76%) gynecologists routinely advice pap smear to the patients, 54 (25.23%) gynecologists advice pap smear to the patients only if it is indicated. 102 (47.66%) gynecologists and spouses have got their own pap smear done. 192 (89.71%) were doing their self breast examination regularly and 66 (30.84%) had done their mammography. 168 (78.50%) had their ultrasound done and 98 (45.79%) had their P/V done. 132 (61.68%) are advising HPV vaccination to the patients routinely and 48 (22.42%) gynecologists had given HPV vaccination to their daughters.Conclusions: Proper and effective utilization of available facilities would depend on creating better understanding and change in their outlook. Stepping up and strengthening of preventive health care services is essential

Antenatal screening for aneuploidy

Background: It is uncertain how best to screen pregnant women for the presence of fetal Down's syndrome and other aneuploides, whether to perform first-trimester screening or to perform second-trimester screening or both.Methods: Women with singleton and multiple pregnancies underwent first-trimester combined screening (measurement of nuchal translucency, pregnancy-associated plasma protein A [PAPP-A], and the free beta subunit of human chorionic gonadotropin at 10 weeks 3 days through 13 weeks 6 days of gestation). Also, second-trimester quadruple screening (measurement of alpha-fetoprotein, total human chorionic gonadotropin, unconjugated estriol, and inhibin A) and triple marker test was done from 15 to 18 weeks of gestation.Results: 12 (5%) patients had positive screening test for combined screening in first trimester, 6 (10.9%) patients had positive screening for quadruple test while 1 (2.85%) patients had positive screening for triple test. Out of 19 positive screening, 16 (84.21%) had their amniocentesis done for confirmation of diagnosis. In all 16 patients, chromosomal analysis was normal. Not a single patient turned out to have a baby with Down syndrome or any other aneuploidy. False positive rate for combined screening in first trimester was 5%, false positive rate for quadruple test in second trimester was 10.9%, false positive rate for triple marker test in second trimester was 2.85%.Conclusions: First-trimester combined screening is better than second-trimester quadruple test or triple marker test for syndrome or any other aneuploidy