Bains K, Saha SC, Aggarwal N
… +3 more, Jain A, Saini S, Eragam A
J Obstet Gynaecol India
· 2025 Jun · PMID 40584802
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PURPOSE: To evaluate the perinatal outcome of early severely alloimmunised pregnancies. METHODS: This was a prospective observational comparative study of all Rh alloimmunised women who required IUT in less than 26 weeks...PURPOSE: To evaluate the perinatal outcome of early severely alloimmunised pregnancies. METHODS: This was a prospective observational comparative study of all Rh alloimmunised women who required IUT in less than 26 weeks of gestation. Outcome measures such as abortion, stillbirth, perinatal survival, and neonatal outcomes were compared with those who required IUT after 26 weeks gestation. Thinner needle (22G) and intrahepatic route preferentially were used for early transfusions. RESULTS: Out of forty-four patients, 22 required transfusion at early gestation. A total of 152 IUT's were given in both groups. Mean number of IUT's was 4.5 ± 2 and 2.2 ± 1.4 in early and late group, respectively. There were two abortions in early group. One stillbirth occurred each in early & late groups while there were three neonatal deaths in late group. Hydropic foetuses were more likely to survive when they were treated early in gestation (80% vs. 66%). Take-home baby rate was 86.3% in early group which was higher than in late transfusion group (82.6%). CONCLUSION: Proper technique and appropriate skill can reduce early IUT complications and improve survival. Results can be as good as those of foetuses who have late transfusions. Hydrops foetuses are more likely to survive if diagnosed and treated early.
Arora N, Kashyap P, Saren D
… +3 more, Meel P, Ghosh J, Yadav A
J Obstet Gynaecol India
· 2025 Jun · PMID 40584801
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BACKGROUND: The precise interpretation of thyroid function tests during pregnancy needs population-based trimester-specific data among pregnant women. This study was to determine trimester-specific reference range for fr...BACKGROUND: The precise interpretation of thyroid function tests during pregnancy needs population-based trimester-specific data among pregnant women. This study was to determine trimester-specific reference range for free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH) among pregnant women in India. METHODS: In this prospective observational study, asymptomatic pregnant women with single fetus were enrolled from each trimester. Serum FT3, FT4, TSH and anti-thyroperoxidase (anti-TPO) antibodies were estimated using electrochemiluminescence technique. RESULTS: Among 918 pregnant women, 82 women were excluded due to the presence of anti-TPO antibodies (76) and overt hypothyroidism (6). Among the remaining 836 women, 279 (33.3%) were in first trimester, 309 (36.9%) in second and 248 (29.6%) in third trimester. The 5th and 95th percentile values for each trimester were used as reference ranges. For all three hormones, the reference ranges for the first, second and third trimesters were: FT3 (1.59-3.64, 1.60-3.50 and 1.44-3.28 pg/dl), FT4 (0.64-1.12, 0.64-1.05 and 0.60-1.01 ng/dl) and TSH (0.21-4.95, 0.23-4.90 and 0.14-4.59 µIU/ml). The mean and median values for TSH between each trimester showed no statistically significant difference. No specific trend was seen for FT3 and TSH with advancing gestation. FT4 showed a decreasing trend with advancing trimester (P value: first versus second = 0.01, first versus third = 0.00003 and second versus third = 0.004). The reference range ( = 836) irrespective of trimester for thyroid hormones was: FT3 (1.53-3.46 pg/dl), FT4 (0.63-1.08 ng/dl) and TSH (0.19-4.72 µIU/ml). CONCLUSION: The trimester-specific reference levels of TSH among pregnant women from India are significantly higher than 4 mIU/L (American Thyroid Association 2017).
J Obstet Gynaecol India
· 2025 Jun · PMID 40584800
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Endometriosis is considered 'silent disease' but is debilitating that impacts quality of life. It is chronic, benign condition which is oestrogen dependent and has chronic inflammatory component. Endometriosis is associa...Endometriosis is considered 'silent disease' but is debilitating that impacts quality of life. It is chronic, benign condition which is oestrogen dependent and has chronic inflammatory component. Endometriosis is associated with menstruation with increased sensitivity to oestrogen receptors and with low progesterone levels. Locally produced prostaglandins from endometriotic lesions leads to pain. There is delay in diagnosis by several years, as symptoms are not specific. This can lead to decline in fertility and quality of life. Imaging techniques and bio markers are not very specific but definitive diagnosis can be with Laparoscopy and histopathology. The first line of therapy will be medical, for relief of pain and fertility. Surgery is advised after failure of medical therapy, for severe degree of disease and deep infiltrating endometriosis (DIE). Assisted reproductive technology (ART) therapy is proposed for improved fertility outcome after surgery. Recurrence is known to occur after therapy.
J Obstet Gynaecol India
· 2025 Jun · PMID 40584799
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The object of this review article is to update on the freezing of oocytes for non-medical reasons. Following a review of increased success rate and safety, the cryopreservation of oocytes is no longer considered experime...The object of this review article is to update on the freezing of oocytes for non-medical reasons. Following a review of increased success rate and safety, the cryopreservation of oocytes is no longer considered experimental. The trend of oocyte freezing is increasing amongst woman who wants to delay childbearing for personal, professional and financial reasons. Very few women return to retrieve their warmed frozen oocytes. The current evidence suggests that there is 70% chance of a live birth following cryopreservation of > 20 M II oocytes at < 38 years of age. However, a larger meta-analysis from different centres is needed to confirm the optimum age for oocyte cryopreservation, the optimum number of oocytes required for live birth, cost-effectiveness and how best to give accurate, unbiased updates to the prospective candidate wanting cryofreezing. In this paper, we have attempted to comprehensively review the literature published on the indications, success rates, factors affecting success rates, live birth rates, counselling, return rates and safety of social egg freezing.
Deoghare M, Nisha N, Kumari R
… +3 more, Sharma JB, Aggarwal A, Khan M
J Obstet Gynaecol India
· 2025 Jun · PMID 40584798
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BACKGROUND: The simultaneous occurrence of uterovaginal and rectal prolapse, i.e. dual prolapse, is uncommon. However, these two conditions can be managed concurrently through a combination of perineal, abdominal and lap...BACKGROUND: The simultaneous occurrence of uterovaginal and rectal prolapse, i.e. dual prolapse, is uncommon. However, these two conditions can be managed concurrently through a combination of perineal, abdominal and laparoscopic approaches. In this article, we present a series of four cases wherein a perineal approach was utilized successfully. METHOD: All 4 patients had varying degrees of uterine prolapse, cystocele and rectocele along with external rectal prolapse. They all had completed their families and provided consent for hysterectomy. One patient underwent vaginal hysterectomy and pelvic floor repair along with the Delorme procedure for rectal prolapse, while the remaining three patients had vaginal hysterectomy and anterior colporrhaphy and posterior colpoperineorrhaphy with levatorplasty. RESULTS: Follow-up evaluation 6 months after surgery revealed complete resolution of symptoms with no vault prolapse and rectal prolapse on examination. It is worth noting that all surgeries were performed under spinal anaesthesia, making this approach suitable for candidates who are at high risk during general anaesthesia, thereby allowing for simultaneous treatment of uterovaginal and rectal prolapse via perineal repair techniques. Also, assistance from surgeons was taken only in one case where Delorme procedure was performed, and in rest 3 cases, satisfactory surgical outcomes were seen following a good posterior colpoperineorrhaphy. CONCLUSION: Concomitant repair of both uterovaginal and rectal prolapse can be successfully performed by combining vaginal hysterectomy along with a good posterior colpoperineorrhaphy or Delorme procedure under spinal anaesthesia.
Kalatehjari M, Ghasemi Y, Mahmoudiandehkordi S
… +3 more, Afrazeh F, Abbasi H, Ghasemi F
J Obstet Gynaecol India
· 2025 Jun · PMID 40584797
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BACKGROUND: Embryo quality assessment plays a pivotal role in assisted reproductive technology (ART) for selecting viable embryos for implantation. Accurate evaluation is essential for improving success rates in fertilit...BACKGROUND: Embryo quality assessment plays a pivotal role in assisted reproductive technology (ART) for selecting viable embryos for implantation. Accurate evaluation is essential for improving success rates in fertility treatments. Traditional assessment methods rely on subjective visual grading by embryologists, which can lead to inconsistencies. The application of deep learning in this domain offers the potential for objective and reproducible assessments. MATERIALS AND METHODS: This study investigates the use of deep learning models to classify embryo images as good or not good at the day-3 and day-5 stages. A dataset obtained from Hung Vuong Hospital in Ho Chi Minh City was used to train and evaluate four convolutional neural network (CNN) architectures: VGG-19, ResNet-50, InceptionV3, and EfficientNetV2. Performance metrics, including accuracy, precision, and recall, were used to assess model effectiveness. RESULTS: Among the tested models, EfficientNetV2 demonstrated superior performance, achieving an accuracy of 95.26%, a precision of 96.30%, and a recall of 97.25%. These results indicate that deep learning models, particularly EfficientNetV2, can provide highly accurate and consistent assessments of embryo quality. CONCLUSION: The high classification accuracy of EfficientNetV2 underscores its potential as a valuable tool for fertility specialists. By offering objective and consistent evaluations, this approach can enhance fertility treatment efficiency and support prospective parents in their reproductive journey.
Saxena P, Arora SK, Prakash A
… +5 more, Chawla R, Chandrasekar A, Diwakar H, Jain R, Seshiah V
J Obstet Gynaecol India
· 2025 Jun · PMID 40584796
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BACKGROUND: Recognizing the importance of postpartum testing for dysglycaemia after gestational diabetes mellitus (GDM), follow-up visit is recommended by all guidelines; unfortunately, dropout rate for follow-up is very...BACKGROUND: Recognizing the importance of postpartum testing for dysglycaemia after gestational diabetes mellitus (GDM), follow-up visit is recommended by all guidelines; unfortunately, dropout rate for follow-up is very high. OBJECTIVE: Comparison of diagnostic accuracy of early OGTT on day 2 or 3 postpartum with late OGTT at 6-12 weeks for predicting dysglycaemia in women with GDM in index pregnancy. METHODS: A total of 250 women with GDM underwent early WHO OGTT testing at 2-3 days postpartum, repeated at 6-12 weeks postpartum. Diagnostic accuracy, sensitivity, specificity, AUC, NPV, and PPV of early OGTT were calculated with 6-12 weeks OGTT as the gold standard. RESULTS: Of the 250 women, 100% completed glucose testing at 2-3 days postpartum while 86% returned at 6-12 weeks for repeat testing despite repetitive phone calls. At 2-3 days of testing, 26.80% women had impaired fasting glucose (IFT), 26.40% women had impaired glucose tolerance (IGT), and 3.20% women had DM. At 6-12 weeks testing, 25% had IFT, 29.81% had IGT. Early OGTT had a sensitivity of 86.15%, specificity of 91.61%, AUC of 0.89, NPV of 93.57%, PPV of 82.35% for predicting dysglycaemia. 51.6% were found to be suffering from metabolic syndrome during 2nd postpartum visit. CONCLUSION: Early OGTT has the advantage of 100% coverage of women with GDM and may have comparable accuracy to conventional OGTT at 6-12 weeks postpartum in detecting impaired glucose status. Counselling and appropriate intervention before discharge may support prevention or delay the progression of diabetes and associated metabolic disorders.
J Obstet Gynaecol India
· 2025 Jun · PMID 40584795
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BACKGROUND: Carbon emissions are responsible for global warming. Countries around the world are trying to reduce carbon emission. PURPOSE: This article throws light on carbon neutrality and the need of reducing carbon em...BACKGROUND: Carbon emissions are responsible for global warming. Countries around the world are trying to reduce carbon emission. PURPOSE: This article throws light on carbon neutrality and the need of reducing carbon emissions. METHODS: Operating theatre environment is a site of carbon emissions. Identifying sources and ways to reducing carbon emission by surgeons is a start to achieve a greener surgical environment. RESULTS: The article discusses the aforementioned and the need to achieve better carbon profile of surgical setups without compromising patient safety. CONCLUSION: Global warming is at the forefront of most industries today. The medical field is one such industry which needs to look into the carbon emissions on a day-to-day basis. Reducing sources of carbon emissions will make operating theatres more eco-friendly.
Tholu C, Choudhary A, Bhimgade P
… +1 more, Yadav A
J Obstet Gynaecol India
· 2025 Jun · PMID 40584794
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Fallopian tube prolapse following hysterectomy is an uncommon condition that can be mistaken for vaginal vault granulation tissue or vaginal vault cancer. We present two cases of post-hysterectomy fallopian tube prolapse...Fallopian tube prolapse following hysterectomy is an uncommon condition that can be mistaken for vaginal vault granulation tissue or vaginal vault cancer. We present two cases of post-hysterectomy fallopian tube prolapse that were successfully treated using a combination of laparoscopic and vaginal approaches. Performing hysterectomy combined with routine salpingectomies can prevent fallopian tube prolapse and offer additional protection against tubal and ovarian cancers.
J Obstet Gynaecol India
· 2025 Jun · PMID 40584793
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BACKGROUND: Analgesia is an important aspect in post-operative period. Nowadays, various multimodal approaches are used for pain management in surgical patients. With these numerous options, the best choice in setting af...BACKGROUND: Analgesia is an important aspect in post-operative period. Nowadays, various multimodal approaches are used for pain management in surgical patients. With these numerous options, the best choice in setting after LSCS remains debatable. In this study, safety and efficacy of regional blocks like TAP block with ropivacaine for pain control were analysed. This may emerge as a better option for pain control after LSCS with minimal adverse effects to both breastfeeding neonate and mother. MATERIALS AND METHODS: 250 patients undergoing LSCS (emergency and elective) were prospectively randomized into two groups. One group received intramuscular diclofenac injections thrice daily while another received bilateral TAP block with 20 ml 0.75% ropivacaine. Visual analogue scale (VAS) score, dosage interval, duration of analgesia and rescue dosage requirement between two groups were recorded and analysed. RESULTS: The mean of total VAS score in group receiving TAP block was lower compared to group receiving IM diclofenac sodium (4.08 ± 3.01 Vs. 14.46 ± 3.98). Also TAP block provided longer duration of analgesia (1227.240 ± 408.118 min vs. 212.120 ± 81.506 min) in single administration. More patients of first group required rescue analgesia within 12 h. Seven patients of diclofenac group required stopping and shifting to alternate analgesic due to inadequate uterine contractions and required uterotonics administration. CONCLUSION: 0.75% ropivacaine in TAP block was effective and had better analgesic and safety profile with comparable cost to IM diclofenac and hence should be recommended in this setting.
J Obstet Gynaecol India
· 2025 Jun · PMID 40584792
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AIM: The clinical profile of the disease in southern Nigeria is less reported. This study aims to describe the clinical characteristics and intra-hospital outcomes of PPCM in Ibadan, south-west Nigeria. MATERIALS AND MET...AIM: The clinical profile of the disease in southern Nigeria is less reported. This study aims to describe the clinical characteristics and intra-hospital outcomes of PPCM in Ibadan, south-west Nigeria. MATERIALS AND METHODS: We reviewed 69 cases of PPCM seen in Nigerian Women at the University College Hospital Ibadan between 2006 and 2021. RESULTS: The mean age at presentation was 30.5 ± 6.7 years (age range 18 - 46 years). The mean BMI was 23.5 kg/M. Most were from the low socio-economic group (47/68.1%) and presented postpartum. The majority were primipara; twin pregnancy was seen in four (5.8%), and PIH occurred in 10 (14.5%) cases. Heart failure was the most typical mode of presentation. Over 90% of the women had spontaneous vertex delivery. Fetal death was recorded in three (4.3%). Two women died. Both presented with severe heart failure and died within few days on admission. CONCLUSION: PPCM in Ibadan, Nigeria, is relatively a disease of primipara from poor homes and in unbooked pregnant women. Improvement in maternal health will be invaluable in prevention of the condition in Nigeria.
Dwivedi JS, Shah DR, Desai GS
… +2 more, Mali KA, Mayadeo NM
J Obstet Gynaecol India
· 2025 Jun · PMID 40584791
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BACKGROUND: Leptospirosis is one of the most prevalent zoonoses worldwide. Its presentation is varied in severity and non-specific mimicking other infectious diseases and pregnancy conditions such as HELLP or AFLP. AIMS...BACKGROUND: Leptospirosis is one of the most prevalent zoonoses worldwide. Its presentation is varied in severity and non-specific mimicking other infectious diseases and pregnancy conditions such as HELLP or AFLP. AIMS AND OBJECTIVES: This study aims to evaluate the maternal and foetal outcomes of leptospirosis and estimate its prevalence in pregnancy at a tertiary care centre. METHODS: This is an observational descriptive study conducted at a tertiary care teaching hospital in Western India over a duration of 5 years. All pregnant patients diagnosed as leptospirosis via IgM ELISA were included. RESULTS: A total of 37 patients were enrolled. Majority presented in the first trimester and belonged to the low socio-economic strata. Fever was the most persistent symptom. Five patients had a spontaneous abortion, two underwent MTP, eight had a preterm delivery, whereas 22 patients carried up till term (of which 18 delivered vaginally and four underwent a LSCS). Majority had leucocytosis and were anaemic. Twelve cases had hyperbilirubinaemia, six had deranged transaminases, three had raised serum creatinine values and two had thrombocytopenia. Four patients required management in the ICU out of which two progressed to Weil's disease and one succumbed to death. The research team at our centre yielded an estimated 9.06% prevalence of leptospirosis. CONCLUSION: Leptospirosis is often underdiagnosed and hence under-reported. Being a re-emerging infectious disease, an early clinical suspicion and sound understanding of the disease process in pregnant women is required.
J Obstet Gynaecol India
· 2025 Apr · PMID 40390984
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INTRODUCTION: When amniotic fluid leaks from the vagina, due to rupture of membranes (ROM) before uterine contractions begin, at a gestational age shorter than 37 weeks, the condition is known as preterm premature ruptur...INTRODUCTION: When amniotic fluid leaks from the vagina, due to rupture of membranes (ROM) before uterine contractions begin, at a gestational age shorter than 37 weeks, the condition is known as preterm premature rupture of foetal membranes. ROM before the onset of labour, after 37 weeks, is known as pre-labour rupture of foetal membranes. Our study sought to examine whether vaginal fluid creatinine levels might be utilised to diagnose women with ROM. OBJECTIVES: To study the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of vaginal fluid creatinine in diagnosis of rupture of membranes. METHODS: The study included 60 pregnant women with singleton pregnancy who were admitted to MVJMC & RH and met the inclusion criteria with gestational age between 28 and 40 weeks. This was a hospital-based prospective comparative study. The study group included 30 pregnant women who complained of vaginal fluid leak (case group) and 30 pregnant women without ROM, who were randomly enrolled from the labour room (control group). If obvious 'leaking' was present then 3 ml of vaginal fluid sample was collected with a syringe. If the membranes were intact then 5 ml of sterile saline solution was instilled into the posterior vaginal fornix and 3 ml of the fluid was withdrawn with same syringe, and sent for vaginal fluid creatinine level estimation. RESULTS: In case and control groups, the mean and standard deviations of vaginal fluid creatinine was 1.50 ± 0.25 mg/dL and 0.52 ± 0.28 mg/dL, respectively. The ideal cutoff score was established using the receiver operator characteristic (ROC) curve coordinates by balancing sensitivity and specificity. The cutoff score of 1.050 mg/dL was selected, with a 93.1% sensitivity rate, a 90.3% specificity rate, 90.0% PPV, and 93.3% NPV. CONCLUSION: A quick, easy test that can accurately diagnose ROM, is the detection of creatinine levels in vaginal fluid. It has high sensitivity, specificity, PPV, and NPV.
Sharma JB, Arora B, Kumari R
… +2 more, Nisha, Deoghare M
J Obstet Gynaecol India
· 2025 Apr · PMID 40390983
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BACKGROUND: Urogynaecological problems are common in puerperium and are mainly related to mode of delivery being more common in vaginal delivery. It was a prospective study of over 300 puerperal women to see the prevalen...BACKGROUND: Urogynaecological problems are common in puerperium and are mainly related to mode of delivery being more common in vaginal delivery. It was a prospective study of over 300 puerperal women to see the prevalence of various urogynaecological problems in vaginal delivery (149 cases) vs caesarean section (151 cases). METHODS: It is a prospective longitudinal observational study in which over 300 women underwent screening for urogynaecological problems in the first week postpartum. Women with urogynaecological symptoms were followed for 6 weeks for the persistence of symptoms, and those with moderate-to-severe symptoms were evaluated using urodynamic studies. RESULTS: The two groups were similar in general characteristics, mean age (28.2 years vs. 26.9 years), parity (2.3 vs. 2.0), gestation (37.5 vs. 38.4 weeks) and socioeconomic status. Mean birth weight was also similar in two groups, group I with 2.62 ± 0.43 kg vs 2.75 ± 0.45 kg in group II (p value 0.35). Overall, 95 cases (31.6%) had urogynaecological symptoms in the first week postpartum and 22 cases (7.3%) had urogynaecological problems at 6 weeks postpartum with many patients showing more than one symptom. There were no significant differences in various urogynaecological symptoms in vaginal delivery (group I) and caesarean section (group II). CONCLUSION: The prevalence of various urogynaecological symptoms was seen in 31.6% in the first week and 7.3% at 6 weeks postpartum and didn't differ with mode of delivery.
J Obstet Gynaecol India
· 2025 Apr · PMID 40390981
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Pubic symphysis septic arthritis is a rare condition mainly associated with pregnancy. Fewer than 35 cases have been reported. We report a case that occurred after delivery by caesarean section, and which was due to . Ma...Pubic symphysis septic arthritis is a rare condition mainly associated with pregnancy. Fewer than 35 cases have been reported. We report a case that occurred after delivery by caesarean section, and which was due to . Management involved three lines of antibiotic therapy and surgical debridement. The combination of this rare pathology and a germ often considered commensal led to an erratic diagnosis for almost six years. One of the consequences, in addition to chronic pain, was destabilization of the pelvic girdle, necessitating surgery. After more than 18 months of follow-up, there was no relapse.
Samy KS, Asnani M, Agarwal A
… +2 more, Singh R, Ali W
J Obstet Gynaecol India
· 2025 Apr · PMID 40390980
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INTRODUCTION: Placenta accreta spectrum (PAS) disorders and placenta praevia (PP) are major life-threatening obstetric complications. Pro-brain natriuretic peptide (ProBNP) and troponin I are circulatory biomarkers relat...INTRODUCTION: Placenta accreta spectrum (PAS) disorders and placenta praevia (PP) are major life-threatening obstetric complications. Pro-brain natriuretic peptide (ProBNP) and troponin I are circulatory biomarkers related to increased angiogenesis and tissue destruction. AIMS AND OBJECTIVES: The aim was to evaluate the ProBNP and troponin I levels in placenta praevia and PAS and compare their levels between cases and their corresponding matched controls in terms of age, gestational age, and BMI. MATERIAL AND METHODS: A case-control study was conducted over one year; ProBNP and troponin I levels were evaluated and compared in a total of 120 women enrolled, in which 30 women were of placenta praevia, 30 women were of PAS, and 60 controls (30 each) matched to corresponding controls in terms of age, gestational age, and BMI. In all recruited women, biomarker levels were detected by immunofluorescence assay method. All cases and controls were evaluated and compared in terms of demographic profile, risk factors, and maternal and perinatal outcomes. RESULTS: In placenta praevia patients, lower mean ProBNP (0.42) and higher troponin I levels (1.58) were observed as compared to their matched controls, but this difference was not significant statistically. PAS patients had statistically significant higher mean ProBNP (1.24) as well as troponin I levels (3.84) as compared to their matched controls ( < 0.001) (z = 4.356). CONCLUSION: Both ProBNP and troponin I levels were found to be higher in cases of PAS. Troponin I had an edge over ProBNP in the identification of PAS and adverse maternal and perinatal outcomes. Both may be used as diagnostic as well as prognostic markers in the future.