Journal Of Obstetrics And Gynaecology Of India[JOURNAL]
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200 papers
Knowledge, Attitude, and Practice Toward Medication Use During Pregnancy: A Hospital-Based Cross-Sectional Survey.
Goruntla N, Ganzi N, Otturu M … +6 more , Vaddi SN, Mood SL, Suchitra MJ, Veerabhadrappa KV, Ezeonwumelu JOC, Bukke SPN
J Obstet Gynaecol India · 2025 Apr · PMID 40390978 · Full text
PURPOSE: Medication (prescription or nonprescription) use during pregnancy is associated with a risk of harm to maternal and fetal health. Pregnant women's knowledge, attitude, and practice (KAP) toward safe medication u...
PURPOSE: Medication (prescription or nonprescription) use during pregnancy is associated with a risk of harm to maternal and fetal health. Pregnant women's knowledge, attitude, and practice (KAP) toward safe medication use can influence positive outcomes. The study aims to assess and explore the risk factors associated with KAP toward medication use during pregnancy. METHODS: An interview-based, cross-sectional survey was conducted among pregnant women attending the obstetrics and gynecology department of a secondary care referral hospital. A predesigned, validated 24-item questionnaire was used to assess the KAP toward medication use among pregnant women. A binary logistic regression analysis was used to identify factors associated with the KAP levels of pregnant women. RESULTS: A total of 300 pregnant women with a mean (SD) age of 24.6 (3.9) years have participated in this study. The study shows that the majority of pregnant women have good knowledge (75.33%), and a positive attitude (91.33%) toward safe medication use, but the rational practice is very low (35.00%). Factors, like advanced age, urban residence, higher education level, and healthcare job, were significantly positively associated with good knowledge and rational practice toward safe medication use during pregnancy with a < 0.05. CONCLUSION: The study concludes that pregnant women have good knowledge, and positive attitudes toward safe medication use; still there is a wide gap in transforming this knowledge and behavior into real practice. So, to address the gap identified in the practice of pregnant women, a hospital or community-based sensitization program can be conducted targeting young age, rural residents, illiterates, and non-healthcare professional groups on medication safety during pregnancy.
Ovarian/Tubal Pathology in Premenopausal Women with Breast Cancer: A Prospective Study.
Punneshetty S, Daniel S, Thomas S … +9 more , Sebastian A, Selvamani, Singh A, Chapla A, Danda S, Paul MJ, Thomas A, Peedicayil A, Chandy RG
J Obstet Gynaecol India · 2025 Apr · PMID 40390977 · Full text
INTRODUCTION: Breast cancer is most common cancer among women and hereditary mutations account for 5-10%. HBOC syndrome is most common hereditary mutation affecting breast & ovary. The prevalence of STIC lesions in these...
INTRODUCTION: Breast cancer is most common cancer among women and hereditary mutations account for 5-10%. HBOC syndrome is most common hereditary mutation affecting breast & ovary. The prevalence of STIC lesions in these women ranges from 2 to 12% and that in general population is unknown. Role of risk reduction salpingo-oophorectomy (RRSO) is well established among these women. Surgical ovarian ablation also plays role in hormone positive breast cancers in prolonging their survival by permanent hormone suppression. The role of oophorectomy has different impacts in breast cancer. METHODOLOGY: The study aimed to determine the different indications for oophorectomy and their histologies among premenopausal breast cancer women. This was a prospective cross sectional study of breast cancer women diagnosed ≤ 50 years of age. All these women underwent genetic counselling, gynaecology examination, transvaginal scan &CA 125 testing. Surgery was offered to women with BRCA mutations (RRSO) and also for hormone receptor positive women (surgical ovarian ablation). Histopathologies of these women were analysed using SEE-FIM protocol. RESULTS: A total of 98 breast cancer women were identified. The median age was 41.5 years (SD 5.7) & median CA 125 was 9.3 (IQR 6-20.5). The genetic acceptance rate was 18%. Four patients were germline BRCA 1/2 positive, 1 VUS, 13 negative and 80 didn't opt for test. Ultrasound imaging showed cystic ovaries among 12 patients. Most of them had benign features. Twenty two patients underwent surgery (bilateral salpingo-oophorectomy)-3 BRCA positive and rest for hormone positive breast cancer. Histopathologies were normal except for Krukenberg's mets in one hormone positive breast cancer patient. CONCLUSION: The incidence of germline mutations in our study was 5%. STIC lesions were not detected in our study, attributing to low acceptance of genetic testing. The value of screening for ovarian cancer was limited. Incorporation of genetics into routine gynaecology oncology clinic needs further addressal. Our study opened the doors for the genetic awareness among these young women.
The Efficacy of Therapist-Guided Internet-Based Psychotherapy for Treating Mild to Moderate Depression and Anxiety Among Women Hospitalized with High-Risk Pregnancies.
Shahrokhi S, Basirat Z, Barat S … +5 more , Kheirkhah F, O'Connor E, Mirtabar SM, Gholinia H, Faramarzi M
J Obstet Gynaecol India · 2025 Apr · PMID 40390976 · Full text
BACKGROUND: Despite ample evidence of high depression rates among women with high-risk pregnancies, there is limited information available regarding the effectiveness of Internet-based psychotherapies in this population....
BACKGROUND: Despite ample evidence of high depression rates among women with high-risk pregnancies, there is limited information available regarding the effectiveness of Internet-based psychotherapies in this population. This study aimed to assess the effectiveness of internet-based psychotherapy in treating depression and anxiety in pregnant women with high-risk pregnancies admitted to the hospital. METHODS: In a quasi-experimental study, 60 inpatient women with high-risk pregnancies exhibiting mild to moderate depression were allocated to either the experimental ( = 30) or control ( = 30) group. The experimental group received medical therapy with Internet-based Synchronous Individualized Therapy for six sessions, each lasting 50-60 min, conducted over six weeks. The control group solely received medical therapy. All participants completed questionnaires, including the Brief Symptom Inventory (BSI-18) and Edinburgh Postnatal Depression Scale, at both baseline and the post-trial stage (6 weeks after the study commencement). RESULTS: The mean scores for depression and anxiety in both groups were elevated (experimental group: = 11.36, SD = 4.84; = 13.82, SD = 4.78; control group: = 11.4, SD = 4.8; = 13.6, SD = 4.6). Symptom severity decreased more significantly in the group receiving internet psychotherapy in addition to medical treatment than in the control group, with medium effect sizes observed for depression symptoms ( = 0.145, = 0.003) and anxiety symptoms ( = 0.238, < 0.001). Furthermore, the reduction in anxiety and depression scores in the internet psychotherapy group was notably more significant than in the control group, with a moderate effect size ( = 0.177, = 0.041). CONCLUSION: Augmenting medical therapy with therapist-guided internet-based psychotherapy may effectively reduce depression, anxiety, and psychological distress in pregnant women experiencing high-risk pregnancies and comorbid depression. These findings suggest that hospitalized, depressed pregnant women with high-risk pregnancies should be offered internet-based psychotherapy as an adjunctive treatment option.
Incorporation of Mean Arterial Pressure in Clinical Practice Using Quality Improvement Initiative.
Ansari S, Yadav R, Jaiswal N … +3 more , Chopra K, Kansara M, Kumar M
J Obstet Gynaecol India · 2025 Apr · PMID 40390975 · Full text
OBJECTIVES: To increase the practice of measuring mean arterial pressure (MAP) in pregnant women during antenatal check-up from 0 to 70% by 6 months. METHODS: A quality improvement (QI) team ran multiple Plan-Do-Study-Ac...
OBJECTIVES: To increase the practice of measuring mean arterial pressure (MAP) in pregnant women during antenatal check-up from 0 to 70% by 6 months. METHODS: A quality improvement (QI) team ran multiple Plan-Do-Study-Act (PDSA) cycles. The process measure was two weekly assessments of improvement in MAP measurement. The outcome measure was the proportion of women started on aspirin. The pregnancy outcome of the low-risk and high-risk women were compared. RESULTS: A total of 360 antenatal women were evaluated. With successive PDSA cycles, which included bridging knowledge gaps; involvement of a multidisciplinary team; involvement of supporting staff; application of software, the MAP measurement improved from 0 to 90% by the end of the study. Total 120/360 (33.3%) cases were deemed high risk based on the presence of maternal risk factors (OR -7.2 , C/I 1.43-36.50). The sensitivity, specificity, PPV and NPV of the test was 75.0%, 70.4%, 5.7%, 99.2% respectively. Total 14/120 (11.7%) cases at high risk of PE were started on aspirin. PE occurred in 6/106 (7.6%) women who were not on aspirin. CONCLUSION: The successful incorporation of MAP measurement in routine clinical practice could be done in a busy public hospital using POCQI.
Lymphedema in Patients Undergoing Surgery for Endometrial Cancer: A Comparative Study of Sentinel Node Biopsy Versus Complete Pelvic Node Dissection.
Kundur M, Rajanbabu A
J Obstet Gynaecol India · 2025 Apr · PMID 40390974 · Full text
OBJECTIVE: To study the incidence of lymphedema in patients undergoing surgery for endometrial cancer and to see whether sentinel node mapping and biopsy results in reduced rates of lymphedema compared to PLND. METHODS:...
OBJECTIVE: To study the incidence of lymphedema in patients undergoing surgery for endometrial cancer and to see whether sentinel node mapping and biopsy results in reduced rates of lymphedema compared to PLND. METHODS: A retrospective single institution analysis including all patients who underwent surgery with nodal assessment for proven or suspected endometrial cancer between January 2010 and July 2021. Patients without 1-year postoperative follow-up were excluded from analysis. Data were obtained from electronic medical records. Each hemipelvis was considered a unit of study. SPSS v.20 was used for statistical analysis. RESULTS: Of the 816 hemipelvises in 408 patients, 486 underwent SLNB and 330 PLND.Mean age of SLNB group was younger (57 y and 59.8 y, < 0.001). Both the groups had similar confounding comorbidities. A mean of 2 (0-8) nodes were obtained in SLNB group and 7 (range 1-26) in PLND group. Average duration of surgery was 123.3 and 197.4min ( < 0.001), and blood loss was 41 and 221.8 ml ( < 0.001) with SLNB and PLND, respectively.Side-specific lymphedema occurred in 6.37% with PLND and 1.23% with SLNB ( < 0.001). Additionally, 1.7% patients in the PLND group and none in SLNB group reported heaviness of the lower limb without clinically obvious edema ( = 0.005). Two patients with edema after SLNB had varicose veins ipsilaterally. Pelvic Lymphocele was seen in 2.33% patients after PLND and 0.19% after SLNB ( = 0.010). CONCLUSION: The present study shows that SLNB is associated with substantially reduced incidence of lymphedema with significantly lower operative time and blood loss.
Laparoscopic Pectopexy: A Novel Technique to Manage Pelvic Organ Prolapse; An Original Study in Asian Women in Rural Area.
Jain N, Kamra J, Srinivas S
J Obstet Gynaecol India · 2025 Apr · PMID 40390973 · Full text
BACKGROUND: Pelvic organ prolapse is a common gynecological disorder seen in Asian women, more in rural area. It is seen in both old age and young women. Presenting complaints includes something coming out of vagina, chr...
BACKGROUND: Pelvic organ prolapse is a common gynecological disorder seen in Asian women, more in rural area. It is seen in both old age and young women. Presenting complaints includes something coming out of vagina, chronic pelvic pain, urinary and bowel symptoms. Sacrohysteropexy is the gold standard procedure for its management. Recently, laparoscopic pectopexy is described as a new alternative procedure, which is equally effective and associated with far lesser complications. Thus, this study is conducted to see the outcomes of laparoscopic pectopexy. METHOD: This retrospective observational study is conducted in the department of obstetrics and gynecology, over the period of three years. Thirty-five patients, operated by laparoscopic pectopexy, were included in study. Twenty-five cases were young patient with prolapse, while 10 patients were of vault prolapse. Inclusion criteria were POP-Q stage ≥ II. All cases were done by same surgical team. Data were analyzed in terms of demographic profile. Video recording of surgery were checked to calculate operating time and estimated blood loss. All intraoperative and postoperative complications were recorded. Follow-up was done at 1 month and 6 months. RESULTS: Out of 35 cases, 10 were vault prolapse and 25 cases were uterine prolapse. No major intraoperative complications like visceral injury and major hemorrhage were found. Average operating time was 96 min. Average estimated blood loss was 50-100 ml. All patients were followed up at 1 month, 3 months and 6 months postoperatively. All patients were highly satisfied with surgery. None of the patients had de novo apical prolapse/recurrence of symptoms. CONCLUSION: Laparoscopic pectopexy is a novel promising technique to manage prolapse with minimal intraoperative and postoperative complications. It is a safe and feasible alternative to sacropexy. So, it should be considered as a first-line surgery for management of apical prolapse.
Pedicled Anterolateral Thigh Flap (ALT) for Vulva Reconstruction: Journey to a New Horizon.
Begum D, Barmon D, Baruah U … +4 more , Darak S, Aparajita R, Kumar M, Bassetty KC
J Obstet Gynaecol India · 2025 Apr · PMID 40390972 · Full text
Surgery for vulval malignancies necessitates extensive resection necessitating the use of musculocutaneous grafts. We present one such case where the patient needed both a V-Y plasty and an anterolateral thigh flap to en...
Surgery for vulval malignancies necessitates extensive resection necessitating the use of musculocutaneous grafts. We present one such case where the patient needed both a V-Y plasty and an anterolateral thigh flap to ensure a tension-free repair. She underwent a partial deep vulvectomy followed by V-Y plasty and ALT flap. The procedure has been described in detail along with intraoperative photographs. She recovered uneventfully and is receiving post-operative adjuvant radiotherapy. We would like to highlight this "additional skill" of plastic surgery which will empower surgeons to undertake radical surgeries to ensure the best outcomes for patients.
Spatial Clustering of Pregnancy Wastage and its Determinants in Manipur: Evidence from National Family Health Surveys.
Hijam M, Singh KJ, Haobijam S … +5 more , Alee NT, Rozer NA, Singh HN, Naorem A, Gonmei P
J Obstet Gynaecol India · 2025 Apr · PMID 40390971 · Full text
BACKGROUND: Pregnancy-related deaths and complications have remained unacceptably high, particularly in low- and middle-income countries. Manipur is the most prevalent state for pregnancy wastage in India with an increas...
BACKGROUND: Pregnancy-related deaths and complications have remained unacceptably high, particularly in low- and middle-income countries. Manipur is the most prevalent state for pregnancy wastage in India with an increasing trend over the last two decades. AIM: The study aims to explore the level, pattern, spatial clustering, and determinants of pregnancy wastage in Manipur. DATA AND METHODS: We utilized the NFHS-4 (2015-2016) and NFHS-5(2019-2021) data of Manipur. The Getis-OrdGi* spatial statistical tool was used to identify the hotspots clusters. Bayesian logistic regression analysis was applied to identify the determinants of pregnancy wastage. RESULTS: The major hotspot clusters for pregnancy wastage were found in the valley districts, namely Imphal East, Imphal West, Thoubal, and Bishnupur. Further, a significant decline in hotspot clusters can be seen in the last five years. BMI was found to be a significant determinant for both abortion and miscarriage. Education, working status, number of antenatal care visits, wealth index and use of smokeless tobacco were associated with higher risks of having abortion among women. CONCLUSION: The results highlight the need to develop district- centric antenatal care services to reduce the risk of pregnancy-related complications. Intervention should be tailored according to the life style choices and unique cultural practices of women in Manipur, India. It may also be beneficial to study the factors associated with declining hotspot clusters in some districts of Manipur.
Provision of Sensitive Medico-Legal Care to Sexual Violence Survivors in a Tertiary Public Health Facility of Maharashtra.
Gadappa SN, Deshpande SS, Gaikwad RA … +4 more , Arora S, Gaddikeri M, Muralidhar K, Deshmukh A
J Obstet Gynaecol India · 2025 Apr · PMID 40390970 · Full text
BACKGROUND: Healthcare providers play an important role in responding to violence against women. The healthcare providers have an important role as expert witness in trials related to sexual violence. In India, several p...
BACKGROUND: Healthcare providers play an important role in responding to violence against women. The healthcare providers have an important role as expert witness in trials related to sexual violence. In India, several policy and legal reforms like MoHFW guidelines and Criminal Law Amendment have been done to establish a sensitive response to survivors of sexual violence. However, several gaps continue to exist in health systems' response in cases of sexual violence. To fill this gap, this paper presents the findings from a tertiary health facility which has implemented evidence-based standardized guidelines for providing care to sexual violence survivors. METHODS: The study was carried out in the OBGY department of a tertiary public health facility of Aurangabad, Maharashtra. The findings are based on the analysis of medicolegal records of 78 cases of sexual violence which came to hospital over a period of 6 months. The information about the profile of survivors, nature of violence, health consequences and compliance to standardized guidelines for medico-legal care was assessed. Additionally, the study also presents findings from in- depth interviews with trained doctors to understand their experiences of providing care and testifying in court in cases of sexual violence. RESULTS: About 42% of survivors were adult and majority of them gave history of violence from a known abuser (83%). In 82% cases, the survivors reported penetrative sexual violence. The analysis of records indicated sensitive medico-legal care in form of operationalization of informed consent in all cases, collection of relevant samples for evidence collection (93%), and mention of irrelevant comment on hymen in 10 cases. The interviews with providers indicated the need to sensitize police and judges about relevance of medical evidence. CONCLUSION: Inservice training of HCPs and system level changes are essential for sensitive medico-legal care.
A Cohort Study of Pregnancy and Fetal Complications Among Patients with Rheumatologic Disorders.
Tafreshian S, Salari M, Mirfeizi Z … +3 more , Akhlaghi S, Samadi S, Sahebari M
J Obstet Gynaecol India · 2025 Apr · PMID 40390969 · Full text
OBJECTIVE: We aim to investigate the maternal and fetal complications among women with rheumatic diseases (RDs) and evaluate the risk factors for adverse pregnancy outcomes. METHODS: In this cohort study, 241 women (comp...
OBJECTIVE: We aim to investigate the maternal and fetal complications among women with rheumatic diseases (RDs) and evaluate the risk factors for adverse pregnancy outcomes. METHODS: In this cohort study, 241 women (comprising 401 pregnancies) who were diagnosed with RDs and sought treatment between 2016 and 2021 were evaluated and followed up for a duration of two years. Clinical backgrounds, pregnancy history, medication usage, immunological characteristics, and pregnancy outcomes were analyzed. Risk assessment for adverse outcomes in RDs was performed using binary logistic regression. RESULTS: The study revealed a 38.2% miscarriage rate and 56.9% live birth rate among 401 pregnancies. Maternal adverse events included gestational hypertension (4.7%), gestational diabetes mellitus (2.7%), and (pre)eclampsia (1.7%). Fetal adverse outcomes consisted of miscarriages in 153 (38.2%), low birth weight in 45 (11.2%), preterm labor in 20 (5%), and fetal heart block in eight (2%). Risk factors associated with adverse fetal outcomes were systemic lupus erythematosus (SLE) (OR 8.24, 95% CI 1.65-41.15), vasculitis (OR 8.06, 95% CI 2.7-24.02), SLE/Sjögren's syndrome (SS) overlap (OR 4.05, 95% CI 1.8-9.11), and history of hypothyroidism (OR 2.81, 95% CI 1.52-5.2). CONCLUSION: RDs exerted a negative impact on pregnancy outcomes, resulting in complications for both the mother and the fetus. Our study emphasizes the significance of effectively managing RDs during pregnancy, with particular emphasis on SLE, vasculitis, and the overlap of SS with SLE. To improve pregnancy outcomes, a multidisciplinary approach, early identification of high-risk patients, and the implementation of individualized treatment plans are recommended.
A Rare Case of Prenatally Diagnosed Pfeiffer Syndrome with Multicystic Kidney.
Sharma P, Kushwaha SS, Dasgupta S … +1 more , Bachani S
J Obstet Gynaecol India · 2025 Apr · PMID 40390968 · Full text
Pfeiffer syndrome is a rare syndromic craniosynostosis characterized by bilateral coronal craniosynostosis, midface hypoplasia, beaked nasal tip, broad and medially deviated thumbs and great toes. It is caused by mutatio...
Pfeiffer syndrome is a rare syndromic craniosynostosis characterized by bilateral coronal craniosynostosis, midface hypoplasia, beaked nasal tip, broad and medially deviated thumbs and great toes. It is caused by mutations affecting the fibroblast growth factor receptors type 1 or 2 (FGFR1 or FGFR2), with autosomal dominant inheritance. It displays substantial clinical and genetic heterogeneity. The disorder is usually detected in the neonatal period, and very few prenatally diagnosed cases have been reported.
Immunohistochemical Diversity of Endometrial Carcinoma and Their Implications in Prognosis: A Prospective Clinicopathological Study in a Tertiary Care Hospital of Eastern India.
Pradhan R, Roy Biswas R, Mondal S … +1 more , Mukherjee U
J Obstet Gynaecol India · 2025 Apr · PMID 40390967 · Full text
BACKGROUND: Endometrial cancer is the sixth most common cancer in women worldwide with gradually increasing incidence and mortality rate. The most recent classification of endometrial carcinoma (EC) with diagnostic flowc...
BACKGROUND: Endometrial cancer is the sixth most common cancer in women worldwide with gradually increasing incidence and mortality rate. The most recent classification of endometrial carcinoma (EC) with diagnostic flowchart includes both immunohistochemical and molecular markers for prognostic purpose and better management of endometrial cancer. In this study, we want to analyze various immunohistochemical (IHC) markers in EC and their prognostic significance. METHODS: This was a prospective study conducted from August 2016 to February 2024. We studied 168 cases of EC for histopathological subtypes, grading and various IHC markers such as Estrogen Receptor (ER), Her 2 Neu, Cytokeratin 5/6, Epithelial Membrane Antigen (EMA) and p53. RESULTS: In our study, most common histological subtype was endometrioid (132) followed by serous (17), mucinous (8), clear cell (7) and carcinosarcoma (4). ER expression was mostly seen in endometrioid type. Loss of ER expression and Her 2 expression along with p53 over expression was not only associated with high grade EC but also with advanced clinical stage and lymph node metastasis. CONCLUSION: Immunohistochemical markers play a definite role in risk stratification and specific individual oriented therapy in endometrial cancer patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13224-024-02046-9.
Vulval Myxoma in a Young Female: An Extremely Rare Occurrence.
Mishra A, Gupta C, Shamsunder S … +2 more , Kolte S, Malik S
J Obstet Gynaecol India · 2025 Apr · PMID 40390966 · Full text
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COVID-19 Vaccination and Infection: Effect on Maternal and Cord Blood Antibody Levels at Delivery.
Nirmanyu HN, Anand P, D'Almeida J
J Obstet Gynaecol India · 2025 Apr · PMID 40390965 · Full text
INTRODUCTION: COVID-19 vaccination produces antibodies against the virus, protecting pregnant women, fetuses, and neonates. The goal was to understand immunologic response to vaccines by pregnant women at different trime...
INTRODUCTION: COVID-19 vaccination produces antibodies against the virus, protecting pregnant women, fetuses, and neonates. The goal was to understand immunologic response to vaccines by pregnant women at different trimesters of pregnancy. OBJECTIVES: To assess maternal blood and cord blood IgG antibody levels against spike protein at delivery in vaccinated pregnant women and in those with COVID-19 infection post-vaccination and to compare immunogenicity profile for different types of COVID-19 vaccine between two groups. METHODS: A cross-sectional study was done on 68 pregnant women with 34 subjects in each group. Maternal and cord blood anti-spike IgG antibody measurements were done in the vaccinated group (group 1) and infected after vaccination group (group 2). RESULTS: Cord anti-spike IgG levels were correlated positively with maternal anti-spike IgG levels ( = 0.935, < 0.001) in group 1 and 2 ( = 0.638, < 0.001). Maternal and cord antibody levels and its transfer ratio in the vaccinated group were higher than in group 2, though not significant. Covishield and Covaxin vaccines elicited comparable rises in antibody levels in both groups. Birth weight was significantly different between the two groups (3.0 ± 0.3 vs. 2.7 ± 0.7 kg, < 0.05). CONCLUSION: Maternal IgG antibody levels against spike protein increased at delivery, in both the groups regardless of the gestational age of vaccination. Vaccinated group showed a trend of higher maternal and cord blood antibody levels and antibody transfer ratio to fetus than in the infected after vaccination group. To enhance neonatal antibody levels, pregnant women need not wait until the third trimester for vaccination.
Evaluation of Bupivacaine Injection Instillation Directly in the Rectus Sheath in LSCS Cases as an Effective Analgesia Method.
Dubey T, Yadav SD, Kundawar A
J Obstet Gynaecol India · 2025 Apr · PMID 40390964 · Full text
BACKGROUND: An ideal post-cesarean section analgesic plan should aim for high-quality pain relief with minimal side effects, no risk of transfer through breast milk, and a faster return to normal maternal functioning. Th...
BACKGROUND: An ideal post-cesarean section analgesic plan should aim for high-quality pain relief with minimal side effects, no risk of transfer through breast milk, and a faster return to normal maternal functioning. This study is aimed to assess the efficacy of analgesic action of direct infiltration of bupivacaine in patients undergoing LSCS. METHODS: This was a retrospective cross-sectional record analysis, assessing the medical records of 49 patients who were included from the medical records department of Apollo hospital, Belapur, Navi Mumbai. RESULTS: 49% patients did not require analgesics in the first 12 h postoperatively. The mean time of first demand of analgesia was 3.44 h (SD = 5.45). 61.2% patients were mobilized in 14 h or less postoperatively. In 69.4% patients, oral intake was initiated within 3 h of the surgery. 73.5% patient's initiated breastfeeding immediately after the surgery. At 4 h after surgery, the pain score was an average of 0.49 (SD = 0.79). 79.6% patients did not report postoperative nausea and vomiting. No patients reported wound infection or dehiscence post-surgery. CONCLUSION: Bupivacaine infiltration post-cesarean section is a safe, effective and convenient method since it requires minimal available resources and no additional skills or supervision from medical experts. Hence, it is more suitable, especially in developing countries and rural/peripheral hospitals/maternity centers where the availability of equipment like USG machine may be difficult, making cheap, accessible yet effective analgesic options the need of the hour in post-LSCS patients.
Gene Novel Homozygous Mutation is Related to Fetal Akinesia Deformation Sequence 3.
Komachali SR, Keikhaie KR, Siahpoosh Z … +2 more , Salehi M, Tamandani DMK
J Obstet Gynaecol India · 2025 Apr · PMID 40390963 · Full text
BACKGROUND: Fetal akinesia deformation sequence syndrome with a prevalence of 1 per 13:000 refers to a clinically and genetically heterogeneous disorder recognized by joint contractures, pterygia, fetal hydrops, dysmorph...
BACKGROUND: Fetal akinesia deformation sequence syndrome with a prevalence of 1 per 13:000 refers to a clinically and genetically heterogeneous disorder recognized by joint contractures, pterygia, fetal hydrops, dysmorphic features and lung hypoplasia's common features. Both genetic and parental/external environmental factors can result in this syndrome. mutations will result in Fetal akinesia deformation sequence 3; the inheritance pattern of the named gene is AR and its protein has a major role as a signaling molecule necessary for neuromuscular junction. METHODS: In this study, a couple who had three recurrent abortions were referred to the Genome laboratory of Isfahan in Iran. Pathological, immunological and hormonal tests were requested for the mother in the first stage, and also Giemsa banding karyotype were requested for the father and mother. Next, array comparative genomic hybridization (array CGH) was requested for the aborted fetus sampling, and whole-exome sequencing was done to mutation analysis. RESULTS: Here, for the first time we report a case which contains novel homozygote mutation NM_173660:exon4:c.G481A:p.G161R in gene locates on 4p16.3 as a novel mutation of the gene that is a pathogenic variant and may play an important role in Fetal akinesia deformation sequence 3. CONCLUSION: Homozygote mutation NM_173660:exon4:c.G481A:p.G161R in gene as a pathogenic variant may play an important role in Fetal akinesia deformation sequence 3 that directly results in recurring miscarriage.
Integrating Ultrasound and Histopathological Analysis to Investigate Placental Abnormalities and Blood Flow in Uteroplacental Insufficiency: A Comprehensive Study.
Chavan R, Narkhede HR, Satoskar PR … +1 more , Londhe M
J Obstet Gynaecol India · 2025 Apr · PMID 40390962 · Full text
BACKGROUND: Uteroplacental insufficiency is a condition marked by insufficient blood flow to the placenta during pregnancy. It is imperative to understand the underlying placental pathologies and their clinical implicati...
BACKGROUND: Uteroplacental insufficiency is a condition marked by insufficient blood flow to the placenta during pregnancy. It is imperative to understand the underlying placental pathologies and their clinical implications. OBJECTIVE: To study the prevalence, distribution, and types of placental pathology among women with clinically recognizable subgroups of FGR and abnormal uterine or umbilical artery Doppler findings. METHODS: Abnormal uterine or umbilical artery Doppler of FGR pregnancies was studied with a comprehensive examination of the macroscopic and microscopic abnormalities of 50 placentae. Specific features such as infarction, villitis of unknown etiology, intervillous inflammation, and massive perivillous fibrin deposition were assessed by microscopy. RESULTS: Among the subjects with uteroplacental insufficiency, 98% displayed placental infarcts. Key histopathological characteristics observed in placentas included villous thrombosis (94%), intervillous hemorrhage (98%), and perivillous fibrin deposition (98%). Inflammatory changes such as villitis, intervillositis, and deciduitis were significantly associated with high resistance in the umbilical artery. The ultrasound demonstrated a positive predictive value of 97.8% for detecting placental infarct. CONCLUSION: In pregnancies complicated by uteroplacental insufficiency, macroscopic and microscopic placental abnormalities were prevalent. Conditions such as villitis, intervillositis, deciduitis and abruption showed noteworthy differences between the HIGH flow and AEDF/REDF groups can be used as indicators for postpartum histopathological examination whether delivery occurred timely or not as per findings on color Doppler. Inflammatory changes might be more related to labor events than being indicative of FGR.
Leydig Cell Tumour of Ovary in a Postmenopausal Woman: A Rare Occurrence.
Narayan R, Fernandes SF, Rao SV
J Obstet Gynaecol India · 2025 Apr · PMID 40390961 · Full text
Leydig cell tumours originate from ovarian sex cord stroma and compromise less than 0.1% of all ovarian tumours. Their unregulated testosterone secretion results in hyperandrogenism and virilization. A 62year old postmen...
Leydig cell tumours originate from ovarian sex cord stroma and compromise less than 0.1% of all ovarian tumours. Their unregulated testosterone secretion results in hyperandrogenism and virilization. A 62year old postmenopausal Para 2 patient presented at Father Muller medical college hospital Mangalore with rapidly progressive hirsutism and alopecia since 1 year. Physical examination revealed high grade hirsutism and Internal examination revealed bulky uterus and a 4 x 4 cm right adnexal mass. Pelvic ultrasonography revealed 3.3 x 3.5centimetres right adnexal solid lesion, which was confirmed on MRI. Blood investigations revealed high serum testosterone with normal DHEA-S and serum cortisol. Low dose dexamethasone suppression test confirmed ovary to be the source of elevated testosterone. She underwent stagging laparotomy with frozen section. Frozen section revealed features of benign sex cord stromal tumours. Final histopathological examination revealed pure Leydig cell tumour with Reinke crystals without infiltrated blood vessels or nerves. While investigating a case of postmenopausal hyperandrogenism, ovarian cancers and adrenal cancers should be considered. The final diagnosis is by histopathological evaluation of the tumour which is considered as the gold standard. These postmenopausal virilizing ovarian tumours are most often benign but they require surgery which is the main stay of treatment to control the symptoms. In those patients who have an advanced disease or have recurrence, it is recommended that adjuvant chemotherapy be given.
Trends in Management of Rhesus Alloimmunization Over Two Decades From a Tertiary Care Referral Center in India.
Dadhwal V, Sharma KA, Rana A … +2 more , Sahay N, Deka D
J Obstet Gynaecol India · 2025 Apr · PMID 40390960 · Full text
INTRODUCTION: Hemolytic disease of the fetus and newborn (HDFN) is a serious complication in pregnancy and still remains a cause of perinatal mortality, in developing countries. Antibodies to other red blood cell antigen...
INTRODUCTION: Hemolytic disease of the fetus and newborn (HDFN) is a serious complication in pregnancy and still remains a cause of perinatal mortality, in developing countries. Antibodies to other red blood cell antigens, leading to hemolysis, are being recognized. The aim of the study is to report the outcomes in women undergoing intrauterine transfusions (IUT) for fetal anemia due to rhesus alloimmunization over the last two decades, over 3 time periods from 2002 to 2021 and to report the prevalence of minor antibodies at our center and their effect on perinatal and neonatal outcomes. MATERIAL AND METHODS: A retrospective record review was conducted across two decades between 2002 and 2021 over 3 time periods 2002-2007, 2011-2014, and 2015-2021. The procedures and outcomes of the first two time periods from the same center have been previously reported 7,8. For the third time period, the data were collected from hospital records of maternal and fetal medicine unit of our hospital. RESULTS: The entire data were divided into three time periods. These do not define watertight compartments of change in management protocols but have evolved over the years with different teams and operators. The number of transfusions has remained almost steady throughout these years; however, the percentage being referred with hydrops has decreased. Across the various time periods, a total of 311 women received 882 transfusions. The gestational age range for performing IUTs varied from 18 weeks to 34.5. The majority of the transfusions were performed between 26 and 29 weeks across the time periods. The complication rates have steadily come down over the two decades from 8.57 per procedure to 2.3 per procedure. The POG at delivery gradually increased from 31 to 32 + 6 weeks (39.5%) to between 35 and 36 + 6. The survival rates have remained high with up to 95% survival in the non-hydropic fetuses and 90% in hydropic fetuses. Anti-D antibody was most often combined with anti-C, anti-M or anti-E. In neonates of anti-D and minor antibodies group, the requirement of phototherapy and exchange transfusion was more although it was not significantly different from only anti-D group. The presence of other antibodies in addition to anti-D can be clinically significant, because these combinations reportedly are more frequently associated with therapeutic interventions for the newborn, especially anti-D plus anti-C. CONCLUSION: HDFN still remains a significant problem requiring early surveillance and timely intervention. Although the survival following intervention is quite favorable, it requires intensive management with a robust support from the blood bank. Prevention strategies must be reviewed to reduce the burden of the disease.
Prevalence of Mismatch Repair Gene Defects by Means of Immuno-histochemistry Staining for MMR Proteins in Endometrial Cancer.
Burde KG, Nair IR, Keechilattu P … +1 more , Rajanbabu A
J Obstet Gynaecol India · 2025 Apr · PMID 40390959 · Full text
INTRODUCTION: In India, the incidence of uterine cancer is 17,420 per year. Presence of mismatch repair genes is one of the risk factors which can cause microsatellite instability in DNA leading to hereditary syndromes a...
INTRODUCTION: In India, the incidence of uterine cancer is 17,420 per year. Presence of mismatch repair genes is one of the risk factors which can cause microsatellite instability in DNA leading to hereditary syndromes as well as sporadic cancer. In the present study, we aim to determine the prevalence of MMR gene mutations by IHC staining for MMR proteins in endometrial cancer. We further aim to corelate various clinic-pathological features with mismatch repair gene defect (MMRd) cancers and to determine its effects recurrence and survival in endometrial cancer. MATERIALS AND METHODS: This is an ambispective study of a retrospectively selected cohort followed up prospectively. It was conducted in the Department of Gynaecological Oncology, AIMS. The cohort was evaluated for the four MMR proteins via IHC staining, and their various clinic-pathological factors were studied. Also, the factors affecting their recurrence free survival (RFS) and overall survival (OS) were observed. RESULTS: The prevalence of MMR loss in endometrial cancer patients was 31.34%. Most common loss of MMR gene was MLH1 and PMS 2 (57.14%). We did not find any significant differences pertaining to age, BMI, menstrual status, family history and second malignancies in both groups of endometrial cancers. While comparing the histopathological characteristics, no significant difference was found regarding to histopathology, stage, type, grade, P53 status, tumour size, lymph node involvement and LVSI status. No significant difference was seen between two groups in RFS and OS. CONCLUSION: We found a significant proportion of endometrial cancers with defective MMR genes in Indian population. We did not find any correlation of MMR to the various clinical and histopathological factors that we analysed. MMRd did not significantly affect the RFS and OS in endometrial cancers.
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