J Obstet Gynaecol India
· 2025 Apr · PMID 40390957
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BACKGROUND: A variety of materials and techniques are used for skin closure after caesarean section (CS), common ones being sutures and staples. The technique chosen should be simple, quick, painless, and provide good co...BACKGROUND: A variety of materials and techniques are used for skin closure after caesarean section (CS), common ones being sutures and staples. The technique chosen should be simple, quick, painless, and provide good cosmesis with least wound complications, and there is a need to identify which provides the best outcome. OBJECTIVES: The aim was to compare metallic surgical staples versus subcuticular sutures for skin closure after caesarean delivery in terms of wound complications, skin closure time, pain score on day 3, and patient satisfaction after 6 weeks. MATERIALS AND METHODS: A total of 300 women undergoing CS with Pfannenstiel incision were randomized into two groups using sealed envelopes. Skin closure was done, and time was noted simultaneously. Wound condition and pain score were assessed on day 3 and 6 weeks post-operatively. RESULTS: On day 3 post-operatively, 22% patients in each group had abnormal healing. After 6 weeks, 1.37% patients with sutures and 3.44% patients with staples had abnormal healing (p value 0.39). Total 10 patients (3.33%), 5 in each group, underwent resuturing within 6 weeks post-operatively. Staples reduced skin closure time as compared to sutures (p value <0.001). Mean pain score was comparable between two groups on day 3 post-operatively (p value 0.08) and at 6 weeks (p value 0.45). Patient satisfaction score considering the appearance and comfort of scar was comparable between both groups (p value 0.25). CONCLUSION: Staples and subcuticular sutures are equivalent to each other, and the choice of skin closure material is at the discretion of the surgeon.
J Obstet Gynaecol India
· 2025 Apr · PMID 40390956
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Accessory cavitated uterine malformation (ACUM) is rare congenital anomaly of uterus, there is accessory cavity with functional endometrium, which does not have any connection to main uterine cavity, due to which patient...Accessory cavitated uterine malformation (ACUM) is rare congenital anomaly of uterus, there is accessory cavity with functional endometrium, which does not have any connection to main uterine cavity, due to which patient typically presents with cyclical abdominal pain which starts after menstruation. Most common complaint being severe dysmenorrhea, which may require taking pain killers every cycle for pain relief, dysmenorrhea not relieving on taking Nsaids and also hormonal treatment will always point toward suspicion of having ACUM. 3D and 4D ultrasonography can help diagnosis the ACUM, hysteroscopy and sonosalphingography could aid in diagnosis, MRI abdomen and pelvis is more specific non-invasive investigation to diagnose as in this case. Surgical excision by laparoscopy is the gold standard treatment in these cases and can offer significant relief in symptoms.
J Obstet Gynaecol India
· 2025 Apr · PMID 40390955
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PURPOSE OF THE STUDY: Glycosylated fibronectin as a predictor of hypertensive disorder and its severity in primigravida. MATERIALS AND METHODS: It is a prospective observational cohort study done in 100 primigravida into...PURPOSE OF THE STUDY: Glycosylated fibronectin as a predictor of hypertensive disorder and its severity in primigravida. MATERIALS AND METHODS: It is a prospective observational cohort study done in 100 primigravida into two groups at 28-38 weeks. Group A consists of 24 patients with risk factors of hypertension but not clinically hypertensive. Group B consists of 76 patients who were already hypertensive. GlyFn levels were determined in maternal serum sample by Lumella test kit, and the ability of GlyFn to assess PE status was analyzed. RESULTS: In Group A, 19 cases were GlyFN positive out of which 14 (73%) developed PE later. In Group B, 100% cases of severe PE showed GlyFN positive ( < 0.001), 80% of non-severe PE were GlyFN positive ( < 0.44) and 95.2% of hypertension cases (on admission) showed GlyFn positive ( < 0.001), and all developed PE later. In Group B, 63 deliveries were within 7 days from testing, out of whom, 62 were GlyFn positive ( < 0.0447).In total of 100 cases, GlyFn was positive in 92 cases out of which 87 had PE, and remaining eight cases had normal GlyFn out of which three had PE ( value < 0.0001). This gives rise to GlyFN test sensitivity of 96.6%, specificity of 50%, PPV of 94.5% and NPV of 62.5%. CONCLUSION: Our study results demonstrate that test has high sensitivity and PPV for preeclampsia that can be a useful adjunct in risk assessment and prediction of preeclampsia.
J Obstet Gynaecol India
· 2025 Apr · PMID 40390953
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BACKGROUND: Ascertaining the nature of adnexal mass in a pregnant woman and timely decision for surgical or conservative management is a dilemma. Present study was conducted to evaluate clinicopathological features and o...BACKGROUND: Ascertaining the nature of adnexal mass in a pregnant woman and timely decision for surgical or conservative management is a dilemma. Present study was conducted to evaluate clinicopathological features and obstetric outcomes of pregnancies with persistent adnexal masses. METHOD: A retrospective study was conducted and case records of pregnant women with persistent adnexal mass diagnosed during pregnancy or incidentally during caesarean delivery (CS), between January 2012 and June 2022 were reviewed. A total of 63 cases were recruited. The clinicopathological profile and clinical outcome were analyzed. RESULTS: During the study period, 63 pregnant women were diagnosed with persistent adnexal masses during pregnancy. Diagnosis was predominantly incidental either during routine USG (54.0%), or during CS (27.0%), and only 12.7% presented with acute abdomen. Forty-two cases were diagnosed during first or early second trimester. Out of these 42 women, 21 were managed conservatively and 11 masses were removed at time of CS. Out of total of 63 pregnancies with adnexal masses, 53 underwent surgical management. The majority i.e., 90% were benign and 10% were malignant; with mature teratoma being most common (32%) histology. In four of five malignant cases, diagnosis was made in antenatal period itself. All benign masses had uneventful course during pregnancy; only one had cyst rupture at 35 weeks and one was diagnosed with malignancy. CONCLUSION: Adnexal masses having benign features on imaging can be managed conservatively till delivery as the chance of missing malignancy is minimal. Surgery for adnexal masses in pregnancy doesn't adversely affect feto-maternal outcomes.
J Obstet Gynaecol India
· 2025 Apr · PMID 40390950
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AIM: Peripartum hysterectomy is defined as removal of uterus at the time of delivery or in immediate postpartum period till 6 weeks. This study had been performed to critically evaluate the incidence, indications, matern...AIM: Peripartum hysterectomy is defined as removal of uterus at the time of delivery or in immediate postpartum period till 6 weeks. This study had been performed to critically evaluate the incidence, indications, maternal and neonatal morbidity and mortality associated with peripartum hysterectomies so that corrective measures both preventive and treatment may be implicated for benefit of women health. METHOD: A retrospective observational study in the Department of Obstetrics and Gynaecology, from 1st January 2013 to 31st December 2022, was conducted after obtaining ethical clearance. Information about all women, who had peripartum hysterectomy obtained from the medical case sheets, were recorded in a structured format which included demographic details, indication of peripartum hysterectomy, maternal and foetal outcome, per operative and postoperative complications, requirement of blood transfusion and need of ventilator support. Statistical analysis was done using the software package SPSS 28 for Windows. RESULTS: Total 478 peripartum hysterectomies were performed during study duration. Incidence of peripartum hysterectomy at our centre was 6.4 per thousand deliveries. 45.8% (219/478) cases of peripartum hysterectomy had rupture uterus. Second most common cause was morbid adherent placenta which was in tune of 19%. Other causes were uterine atony, placenta previa and postpartum sepsis. 47.2% patients required ICU care, 1.25% had bladder injury, 10% had septicaemia, 0.8% required relaparotomy and 57.9% had still birth. CONCLUSION: Although peripartum hysterectomy is uncommon procedure but it is lifesaving procedure so every obstetrician must have expertise in this procedure.
Hassan AA, Alotaibi AF, Almatar FA
… +3 more, Albassam NA, AlQuaiz AM, Kazi A
J Obstet Gynaecol India
· 2025 Apr · PMID 40390948
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BACKGROUND: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder that affects women's health-related quality of life (HRQoL). This study aimed to assess the HRQoL and identify the significant factors associ...BACKGROUND: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder that affects women's health-related quality of life (HRQoL). This study aimed to assess the HRQoL and identify the significant factors associated with it among women with PCOS in Riyadh, Saudi Arabia. METHODS: A cross-sectional study was conducted with 250 Saudi women registered with King Khalid University Hospital (KKUH) in Riyadh. Data were collected using the PCOS questionnaire and the social support survey (SSS) questionnaire. Multiple logistic regression analyses were utilized to explore the association between social support and PCOS HRQoL symptoms. RESULTS: More than 50% of the women reported that PCOS significantly affected their HRQoL. Lack of social support in form of tangible support was significantly associated with severe PCOS symptoms, namely emotions [2.53 (1.01, 6.33)], body hair [2.82 (1.17, 6.84)], weight [2.35 (1.01, 6.09)], and infertility [11.63 (3.94, 34.34)], whereas lack of emotional support was associated with severe menstrual symptoms [1.86 (1.01, 3.76)]. Marital status [3.87 (1.85, 8.10)], aged < 32 years [2.60 (1.27, 5.31)], and housewives [2.69 (1.05, 5.06)] reported severe infertility symptoms. Employed women [2.22 (1.0, 5.06)] reported severe menstrual symptoms, whereas having BMI ≥ 25 kg/m [3.31 (1.80, 6.07)] reported weight-related symptoms. CONCLUSION: This study highlights the significant impact of social support and sociodemographic factors on women's HRQoL in Saudi Arabia. The study implies the need for tailored interventions to improve the HRQoL of women with PCOS, particularly for those who lack sufficient social support. Health policy should focus on creation of social support groups to provide counseling and support to the women at the community level.
Nalwa A, Gowda VN, Bardia A
… +4 more, Singh P, Rao M, Elhence P, Goel AD
J Obstet Gynaecol India
· 2025 Apr · PMID 40390947
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OBJECTIVE: Bcl-2-associated athanogene-3 (BAG-3) is a cytoplasmic multidomain protein member that belongs to the BAG family of co-chaperones that are known to be involved in several cellular processes, including control...OBJECTIVE: Bcl-2-associated athanogene-3 (BAG-3) is a cytoplasmic multidomain protein member that belongs to the BAG family of co-chaperones that are known to be involved in several cellular processes, including control of apoptosis, autophagy, and cytoskeletal dynamics. Normal tissues show weak to negligible expression as it is downregulated. However, its expression is upregulated in various epithelial and hematological malignancies, including endometrial, cervical, and chronic lymphoid leukemia. It plays a vital role in tumor cell proliferation, metastasis, and therapy resistance; thus, its expression has been determined to be a valuable tool in developing targeted therapeutic strategies. Endometrial cancers are one of the most common female genital tract malignancies with high mortality. Therefore, in this study, we evaluated the BAG-3 protein immunoexpression in 33 cases of endometrial cancer and correlated its expression with prognostic determiners. MATERIALS AND METHODS: We performed a retrospective study of BAG-3 immunoexpression in 33 cases of endometrial carcinoma. Cytoplasmic and membranous staining was considered positive and its correlations with prognostic factors such as myometrial invasion, LVSI, and ovarian involvement were analyzed. RESULTS: BAG-3 immunopositivity was seen in 31 (93.9%) cases and two cases were found to be negative. Twenty-two (66.6%) showed strong (3 +) intensity, seven (21.2%) showed moderate, and two (6.1%) showed weak BAG-3 immunostaining. No significant correlation was seen between grade and intensity. CONCLUSION: Inhibiting BAG-3 expression can induce apoptosis, thus promoting a new therapeutic target for the treatment of endometrial carcinoma.
Kushwaha SS, Singhal S, Dhiman S
… +4 more, Kumar S, Roy KK, Meena J, Tomar S
J Obstet Gynaecol India
· 2025 Apr · PMID 40390946
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BACKGROUND: Caesarean section is associated with post-operative surgical complications such as wound disruption, induration and hematoma. It is essential to optimize surgical techniques to ensure the best possible outcom...BACKGROUND: Caesarean section is associated with post-operative surgical complications such as wound disruption, induration and hematoma. It is essential to optimize surgical techniques to ensure the best possible outcomes for women undergoing caesarean section. METHODS: This was a randomized controlled trial done at a tertiary care centre. A total of 300 women undergoing first caesarean section were randomly allocated to absorbable subcuticular sutures ( = 100), non-absorbable nylon sutures ( = 100) and surgical staplers ( = 100) for skin closure. Post-operative wound complications, pain, cosmetic appearance, closure time, and surgeon's and patient's satisfaction were recorded post-operatively on day 3, days 7-10 and at weeks 4-6. The primary outcome was rate of wound disruption among the women in three groups at three occasions. The secondary outcomes were wound infection rate, induration, swelling, cosmetic appearance, pain, surgeon's satisfaction, patient's satisfaction and closure time. RESULTS: Significantly more women developed wound dehiscence in the stapler group ( = 0.039) at post-operative days 7-10 while in sub-group analysis, a similar outcome was seen between the other two groups ( = 0.999). The patient's and surgeon's satisfaction and cosmesis were maximum with absorbable subcutaneous monocryl sutures and minimum with stapler skin closure. Pain was maximum after non-absorbable nylon sutures, while application time was minimum in staplers application. CONCLUSION: Present study suggests a benefit with sutures compared to surgical staplers in terms of wound dehiscence, infection, cosmesis and patient's satisfaction. Among the methods of skin closure, absorbable subcuticular monocryl and non-absorbable nylon sutures have similar outcomes with marginal benefit in absorbable subcuticular monocryl sutures.
Suhashini Karnal C, Sampathkumari S, Chithra S
… +1 more, Alagu Sakthi Sowparnika K
J Obstet Gynaecol India
· 2025 Apr · PMID 40390945
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BACKGROUND: Cervical cancer is the one of the most constantly diagnosed and leading cause of cancer death in women, with an estimated 604,000 new cases and 342,000 deaths worldwide. One woman dies of cervical cancer ever...BACKGROUND: Cervical cancer is the one of the most constantly diagnosed and leading cause of cancer death in women, with an estimated 604,000 new cases and 342,000 deaths worldwide. One woman dies of cervical cancer every 9 min in India. Despite its high incidence, the knowledge and awareness regarding cervical cancer and its screening is limited. This study aims to estimate the proportion of preinvasive lesions of cervix among healthy and immunocompromised individuals. METHODS: An observative cross-sectional study done in a tertiary care centre from January 2021 to June 2022 among 250 normal and 250 immunocompromised individual's attending tertiary care centre. Coloscopy guided biopsy was taken for histopathological examination after informed and written consent. RESULTS: The proportion of preinvasive lesion of cervix among 500 individuals is 8.2% (41). The proportion of preinvasive lesion among normal individuals is 5.2% (13) and among immunocompromised individual is 11.2% (28). Most of the positive cases, 46% (19) were seen in women with more than two children. 75% (31) of positive cases were seen in women who had their first coitus at age less than 21 yrs. 87.8% of positive cases were seen in women not using any method of contraception. CONCLUSION: Preinvasive lesions are more common in immune compromised and it is precisely clear that all women must undergo cervical cancer screening as cervical cancer is the most common among women. "Prevention is better than cure"-Screening and early treatment of preinvasive lesion is cost-effective way to prevent cancer cervix.
J Obstet Gynaecol India
· 2025 Apr · PMID 40390944
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The coexistence of three histologically distinct ovarian tumors is exceedingly rare, posing challenges for accurate diagnosis and management. This case report presents a young woman with concurrent endometriotic cyst and...The coexistence of three histologically distinct ovarian tumors is exceedingly rare, posing challenges for accurate diagnosis and management. This case report presents a young woman with concurrent endometriotic cyst and fibroma in one ovary, as well as a mature cystic teratoma in the other. Surgical priority centered on completely removing the tumors while preserving healthy ovarian tissue. While the dermoid and endometriotic cysts were excised completely through laparoscopy, a laparotomy was necessary to excise the firm, irregular mass (fibroma) and conserve the remaining ovarian tissue. Although laparoscopy is advantageous for removing benign masses, laparotomy may be required for ovarian preservation in patients with multi-pathological involvement of both ovaries.
J Obstet Gynaecol India
· 2025 Apr · PMID 40390943
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MURCS syndrome stands for mullerian duct aplasia, renal anomalies, and cervicothoracic somite anomalies. This is an atypical manifestation of MRKH (Mayer-Rokitansky-Kuster-Hauser) syndrome and is classified as MRKH type...MURCS syndrome stands for mullerian duct aplasia, renal anomalies, and cervicothoracic somite anomalies. This is an atypical manifestation of MRKH (Mayer-Rokitansky-Kuster-Hauser) syndrome and is classified as MRKH type 2. Their usual presentation is for the evaluation of primary amenorrhea, and some may present early for the evaluation of short stature, like in our case. We report a case of a 9-year-old girl who presented with short stature. Its presentation is sporadic in the majority and, in others, may be inherited by an autosomal dominant pattern with incomplete penetrance. So far, candidate genes have been evaluated among the affected families, but clear genetic information is not available. Ovaries are normal in most of the children with MURCS syndrome and may develop normal secondary sexual characteristics. Either uterine transplantation or surrogacy is the option for fertility due to the absence of mullerian derivatives.
Satoiya N, Vayeda M, Desai S
… +2 more, Shah S, Shah P
J Obstet Gynaecol India
· 2025 Apr · PMID 40390942
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PURPOSE: The study aims to assess the uptake and adherence of menstrual cups among tribal-rural women. METHODS: The study was conducted in rural tribal areas of Gujarat from 2018 to 2020. A total of 106 menstruating wome...PURPOSE: The study aims to assess the uptake and adherence of menstrual cups among tribal-rural women. METHODS: The study was conducted in rural tribal areas of Gujarat from 2018 to 2020. A total of 106 menstruating women aged 18-54 years were enrolled. Participants were provided information regarding menstrual cups. Those women who opted were provided menstrual cups (marketed as Ever cups) at Rs. 100 (US $ 1.25). They were followed up for at least three consecutive menstrual cycles. Their experiences were recorded using a structured questionnaire. Uptake was defined as the percentage of women who used menstrual cups at least once. Adherence is the percentage of cycles for which the menstrual cup was used out of the total scheduled processes. RESULTS: Of 106 women, 73 (68.87%) women used the cup at least once. Among them, 55 (75%) women used cups during all menstrual cycles during the study period. 72 (98.63%) users expressed satisfaction with the menstrual cup. The average adherence was 79.91%. The common reasons for the non-usage of the cup were unmarried status and lack of hygienic facilities and privacy. CONCLUSION: The menstrual cup was well accepted among this predominantly working population of married women in rural settings. As per user experiences, the menstrual cup has been easy to use and saved time and money in comparison with prevailing products. However, the cup was less acceptable among unmarried women.
J Obstet Gynaecol India
· 2025 Apr · PMID 40390941
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PURPOSE OF STUDY: The purpose of this study is to analyse the profile and characteristics of patients who may undergo obstetric hysterectomy, to study the intra-operative and post-operative complications of these patient...PURPOSE OF STUDY: The purpose of this study is to analyse the profile and characteristics of patients who may undergo obstetric hysterectomy, to study the intra-operative and post-operative complications of these patients and to increase the preparedness and reduce morbidity and mortality of patients undergoing obstetric hysterectomy. METHODS: After taking approval of the IEC, data of patients who had consented to be a part of the study were collected and analysed. RESULTS: Our study included 30 patients. Twenty-two patients underwent emergency obstetric hysterectomy, with abnormal placentation being the most common indication followed by post-partum haemorrhage. The most common postoperative complication was bladder injuries, and two out of 30 patients eventually succumbed in the post operative period. CONCLUSION: Most of the morbidity associated with OH is attributed to the indications for which OH is done rather than the procedure itself. The indication for obstetric hysterectomy has changed to abnormal placentation from uterine atony and rupture. Future studies and change in management practices should focus on reducing the rate of caesarean sections whenever possible with proper preoperative planning, designing appropriate labour unit protocols and setting up multi-disciplinary units to manage difficult cases.
Limbachiya D, Tiwari R, Padval R
… +2 more, Kumari R, Trivedi P
J Obstet Gynaecol India
· 2025 Apr · PMID 40390939
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Endometriosis-associated neoplasms will develop in 0.7-2.5% of women with endometriosis. We present a rare case report of endometriosis associated endometroid carcinoma of peritoneum. We report a case of 43 years female...Endometriosis-associated neoplasms will develop in 0.7-2.5% of women with endometriosis. We present a rare case report of endometriosis associated endometroid carcinoma of peritoneum. We report a case of 43 years female with chief complaints of menorrhagia, dysmenorrhoea and dyspareunia. Her imaging revealed an endometriotic cyst of in left ovary along with iso to hyperechoic nodular area seen in right iliac fossa. Laparoscopic exploration validated it to be a case of grade IV endometriosis along with presence of peritoneal nodule of 5.5 × 4.5 cm in right iliac fossa. The peritoneal nodular lesion was removed with en bloc wide local excision with clinically disease-free margin. Histopathology report of peritoneal nodule shows endometrioid adenocarcinoma. Complete surgical staging for peritoneal cancer was performed and was not advised any adjuvant therapy. Patient is disease free since last 3 years.