Journal Of Obstetrics And Gynaecology Of India[JOURNAL]
Sun
200 papers
Artificial Intelligence Colposcopy Models for Cervical Cancer Screening and Diagnosis: A Systematic Review and Meta-Analysis.
Priya S, Panigrahi SK, Bansal V … +3 more , Arnav A, Raj M, Rai P
J Obstet Gynaecol India · 2026 Jun · PMID 42369264 · Full text
BACKGROUND: Cervical cancer is a significant public health problem globally, with limited access to screening and diagnostic resources in developing countries contributing to its high burden. Artificial Intelligence (AI)...
BACKGROUND: Cervical cancer is a significant public health problem globally, with limited access to screening and diagnostic resources in developing countries contributing to its high burden. Artificial Intelligence (AI) has emerged as a promising tool to enhance the diagnostic performance of colposcopy, a procedure used to visually examine the cervix for abnormal cell growth. The findings of this study will contribute to the growing body of evidence on the role of Artificial Intelligence (AI) in cervical cancer diagnosis. MATERIALS AND METHODS: This Meta-analysis aims to synthesize data and provide a comprehensive evaluation of the diagnostic performance of AI-assisted colposcopy systems (sensitivity, specificity, and accuracy) for Cervical malignancy and premalignant lesions.A comprehensive literature search was conducted across multiple databases, and 12 studies were included in the Meta-analysis. Pooled estimates of sensitivity, specificity, and accuracy were calculated using a random-effects model, and heterogeneity statistics were computed to evaluate consistency across studies. RESULTS: The pooled estimates of diagnostic performance were sensitivity, 78.1% (95% CI 71.4-84.0%); specificity, 80.6% (95% CI 74.2-85.8%); and accuracy, 83.1% (95% CI 77.8-88.2%). Subgroup analysis and heterogeneity testing were performed to explore sources of variability. CONCLUSION: The results suggest that AI-assisted colposcopy systems demonstrate promising diagnostic performance in Cervical malignancy and premalignant lesions diagnosis. However, substantial heterogeneity underscores the need for methodological standardization and reporting transparency in AI-based diagnostic research. Future research should focus on developing and validating AI models in diverse populations, evaluating clinical utility and cost-effectiveness, and investigating the impact of AI-assisted colposcopy on patient outcomes and healthcare systems. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13224-026-02352-4.
Van Wyk Grumbach Syndrome: Case of Hemoperitoneum with Multiple Ovarian Cysts in a Girl with Precocious Puberty.
Pravallika R, Puranam B, Sethi BK … +1 more , Reddy TP
J Obstet Gynaecol India · 2026 Jun · PMID 42369263 · Full text
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A Randomized Controlled Trial to Compare Vaginal Dinoprostone Pessary with Intracervical Dinoprostone Gel for Pre-induction Cervical Ripening.
Chaudhary MK, Suri V, Bagga R … +3 more , Arora A, Kumar J, Jain V
J Obstet Gynaecol India · 2026 Jun · PMID 42369262 · Full text
PURPOSE: To compare safety and efficacy of vaginal dinoprostone pessary with intracervical dinoprostone gel for cervical ripening at term. METHODS: A hundred women with singleton pregnancies requiring labor induction wit...
PURPOSE: To compare safety and efficacy of vaginal dinoprostone pessary with intracervical dinoprostone gel for cervical ripening at term. METHODS: A hundred women with singleton pregnancies requiring labor induction with a Bishop score of ≤ 6 with intact membranes and no previous Cesarean Section (CS) were randomized to the pessary or gel group. All patients underwent assessment at baseline and every 8 h thereafter, along with the grading of discomfort noted on the visual analog scale (VAS). Pessary was kept for a maximum of 24 h, and the gel was inserted 8 hourly (maximum 3 doses). RESULTS: The pessary group needed fewer assessments during the induction process (2.24 ± 0.82 vs. 2.58 ± 0.61, = 0.004). The change in Bishop's score after 8 h was significantly higher in the pessary group (2.69 ± 1.42 vs. 1.81 ± 1.26, = 0.006). The pessary group had a considerably better VAS score 2.54 ± 1.13 vs. 3.18 ± 1.24, = 0.004), depicting better tolerance of pessary. There was no statistically significant difference between both groups in terms of induction to delivery interval (IDI), mode of delivery, duration of 1st, 2nd, and 3rd stage of labor, type of rupture of membrane, need for intervention, and the indication for intervention. The rate of CS was higher in the gel group, though the difference was not statistically significant. The neonatal outcomes showed no difference. CONCLUSION: Dinoprostone vaginal pessary is faster and better tolerated than cervical gel for cervical ripening at term. The IDI, mode of delivery, and maternal and neonatal outcomes were similar in pessary versus gel groups.
Clinical and Psychosocial Characteristics of Women with Vaginismus: A Retrospective Descriptive Study from a Sexual Health Clinic in India.
Rao A, Gokani N, Sahore A … +2 more , Mensegere A, Deshpande S
J Obstet Gynaecol India · 2026 Jun · PMID 42369261 · Full text
BACKGROUND/INTRODUCTION: Vaginismus, classified as genito-pelvic pain/penetration disorder in DSM-5, is characterized by involuntary pelvic floor muscle contraction, fear of penetration, and anxiety. Despite its impact o...
BACKGROUND/INTRODUCTION: Vaginismus, classified as genito-pelvic pain/penetration disorder in DSM-5, is characterized by involuntary pelvic floor muscle contraction, fear of penetration, and anxiety. Despite its impact on sexual health, it remains underreported, particularly in conservative societies like India. Limited data exist on its prevalence and psychosocial correlates in Indian settings. This study examines the clinical and psychosocial characteristics of women diagnosed with vaginismus at a sexual health clinic in India. METHODS: A retrospective descriptive study analyzed chart data from a sexual health clinic in India (May 2023-May 2024). Women aged ≥ 18 years, diagnosed with vaginismus per DSM-5 criteria, were included. Socio-demographic, clinical, psychiatric, and psychosocial data were extracted and analyzed using descriptive statistics. RESULTS: Of 692 women with sexual dysfunction, 313 (45.23%) had vaginismus. The mean age was 29.4 years (SD = 4.73). Most were from Tier 1 cities (72.8%) and had attempted but not succeeded in intercourse (58.8%). Anxiety and depression were common psychiatric comorbidities, while thyroid disorders and polycystic ovarian syndrome were frequent medical conditions. Partner-related sexual dysfunction occurred in 8.6% of cases. Fear of penetration (57%) and sexual myths (9.2%) were prevalent. CONCLUSIONS: Vaginismus has significant psychosocial and cultural implications. The findings underscore the need for multidisciplinary interventions, including psychotherapy, sexual education, and couple therapy, to improve outcomes and reduce stigma surrounding female sexual health.
Successful perinatal outcome of DCDA twin pregnancy in a bicorporeal uterus.
Ratha C, Kola S
J Obstet Gynaecol India · 2026 Jun · PMID 42369260 · Full text
Diagnosis of Mullerian anomalies in any woman leads to great distress, and the associated uncertainty of pregnancy outcomes is a cause of apprehension for both the woman and her treating clinician. With the advent of mod...
Diagnosis of Mullerian anomalies in any woman leads to great distress, and the associated uncertainty of pregnancy outcomes is a cause of apprehension for both the woman and her treating clinician. With the advent of modern imaging techniques, we are able to diagnose many Mullerian anomalies. Despite the possibility of complications, few cases may have a favorable perinatal outcome when managed with meticulous planning and monitoring based on clinical judgment. We are reporting one such case of successful perinatal outcome of DCDA twin pregnancy in a bicorporeal uterus with information about preconceptional workup, planning and antenatal follow-up till the birth of viable twin babies at term.
New-born Screening for Mitochondrial Disorders is Useful for Genetic Counseling and Early Treatment when Available.
Finsterer J
J Obstet Gynaecol India · 2026 Jun · PMID 42369259 · Full text
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Self-Reported Patient's Continuation Rate, Complications, and Content (3c's Study) with Levonorgestrel Intrauterine System (LNG-IUS) for Heavy Menstrual Bleeding.
Gupta A, Gangane N, Moharana B … +3 more , Dhanvij M, Davile M, Mundle S
J Obstet Gynaecol India · 2026 Jun · PMID 42369258 · Full text
BACKGROUND: Heavy menstrual bleeding (HMB) affects up to one-third of women, who experience HMB at some point in their lifetime, which impacts a woman's quality of life, physically, emotionally, and socially. Aiming that...
BACKGROUND: Heavy menstrual bleeding (HMB) affects up to one-third of women, who experience HMB at some point in their lifetime, which impacts a woman's quality of life, physically, emotionally, and socially. Aiming that treatment and management options should improve the quality of life, LNG-IUS, a hormonal device, is recommended by NICE as first-line treatment for non-structural causes of HMB, such as endometrial hyperplasia, small fibroids (3cm), or adenomyosis. Patient satisfaction is crucial, as it influences treatment adherence. We conducted our study with the primary objective to evaluate continuation rate, expulsion rate, and satisfaction rate after levonorgestrel-releasing intrauterine system (LNG-IUS) insertion for HMB, aiming to promote LNG-IUS use. METHOD: This retrospective cohort study included women who had LNG-IUS inserted for heavy menstrual bleeding between June 2021 and September 2022. Based on a 6% discontinuation rate for LNG-IUS, a 95% confidence level, and a 5% alpha error, the required sample size was 85. Accounting for a 15% loss to follow-up, the final sample size was 98. RESULTS: The response was measured in all 92 women who underwent hysterectomy or expelled the device before complete follow-up. 80/92 (91.3%) were satisfied with the treatment and would recommend it to women with similar complaints. At 12-month follow-up, women had a significant increase in their mean haemoglobin values from the baseline value of 9.35 ± 2.25 gm/dL to 10.4 ± 1.4 gm/dL, and this led to improvement in symptoms of anaemia as well. CONCLUSION: LNG- IUS is highly effective in treating heavy menstrual bleeding without any major side effects; the success rate increases with good case selection. The results from the present study can be used to counsel patients with AUB.
From Continence to Incontinence: Challenges and Advances in Care.
Dalvi S
J Obstet Gynaecol India · 2026 Jun · PMID 42369257 · Full text
Urinary incontinence (UI), defined as involuntary leakage of urine, is a common condition in women, particularly after 50 years of age. Despite its recognition as a disease by the International Classification of Diseases...
Urinary incontinence (UI), defined as involuntary leakage of urine, is a common condition in women, particularly after 50 years of age. Despite its recognition as a disease by the International Classification of Diseases, UI remains underreported due to stigma and misconceptions, with a significant impact on quality of life, mental health, and social functioning. This review outlines the classification of UI (stress, urge, mixed, overflow, functional), underlying pathophysiology, and contributory factors such as ageing, trauma, surgery, and menopause. Evaluation includes detailed history, physical examination, urological tests, and urodynamic studies to differentiate causes and guide management. Management strategies range from lifestyle modification, pelvic floor muscle therapy, bladder training, and medical interventions (antimuscarinics, β3 adrenergic agonists, vaginal oestrogens) to surgical procedures including mid-urethral slings, urethropexy, periurethral injectables, and artificial sphincters. Emerging therapies such as neuromodulation, onabotulinumtoxin A injections, and electromagnetic devices (Emsella chairs) show promise. UI is strongly associated with depression, sexual dysfunction, poor sleep, and reduced productivity. UI is a multifactorial condition requiring patient-centred, multidisciplinary care. Advances in bladder physiology research, genetic studies, and novel therapies targeting bladder microbiota highlight future directions. Early detection, prevention, and improved patient-reported outcomes remain central to enhancing quality of life in affected women.
Impact of Hypothyroidism on Ovarian Reserve in Infertile Reproductive-Aged Women: A Cross-Sectional Study.
Amidi B, Naderi N, Ghafarzadeh M … +3 more , Abasinezhad A, Yari F, Kaviani Charati M
J Obstet Gynaecol India · 2026 Jun · PMID 42369256 · Full text
PURPOSE: The purpose of the study is to evaluate the effects of thyroid function on ovarian reserve in reproductive-aged women attending Barkat Infertility Center and Shahid Rahimi Medical Center, Khorramabad, Lorestan,...
PURPOSE: The purpose of the study is to evaluate the effects of thyroid function on ovarian reserve in reproductive-aged women attending Barkat Infertility Center and Shahid Rahimi Medical Center, Khorramabad, Lorestan, Iran. METHODS/SUBJECTS: Descriptive-analytical cross-sectional research was conducted on 318 infertile women of reproductive age from July 2023 to March 2024. Subjects were selected through random sampling, and the inclusion criteria required infertility for more than a year without any anatomical, genetic, or systemic causes. A history of prior ovarian surgery, chemotherapy, radiotherapy, thyroid diseases, polycystic ovary syndrome, and hyperprolactinemia were all exclusion criteria. Data on demographic and clinical data were gathered, and blood samples were tested for thyroid function (TSH, FT4) and ovarian reserve markers (AMH, estradiol, and FSH). RESULTS: Among the participants, clinical hypothyroidism and subclinical hypothyroidism were found in 10.4 and 3.8% of cases. A significant relationship was identified between TSH and AMH levels. Increased TSH levels and higher FT4 levels were both significantly associated with decreased ovarian reserve, as indicated by AMH < 1.1 ng/mL. Additionally, there were negative correlations for age and BMI with ovarian reserve and positive correlations for estradiol. CONCLUSION: This study concluded that, among infertile women, a significant inverse relationship between thyroid function and ovarian reserve does exist. Higher TSH and FT4 levels were both associated with low levels of AMH; hence, thyroid dysfunction may impair ovarian function. These findings emphasize how imperative complete thyroid investigations are in infertility investigations. Further research is needed to establish the cause and offer specific treatments regarding thyroid disorders and infertility.
A Conservative Approach to Uterovaginal Prolapse: Assessing the Effectiveness and Outcomes of Abdominal Sacrohysteropexy.
Patel TI, Tandale MS, Nagapurkar S … +1 more , Nishat S
J Obstet Gynaecol India · 2026 Jun · PMID 42369255 · Full text
BACKGROUND: Pelvic organ prolapse (POP) is the descent of the pelvic organs including bladder, rectum, uterus, vaginal vault and intestines, beyond their anatomical confines.The goal of uterine conserving surgical altern...
BACKGROUND: Pelvic organ prolapse (POP) is the descent of the pelvic organs including bladder, rectum, uterus, vaginal vault and intestines, beyond their anatomical confines.The goal of uterine conserving surgical alternatives is to improve quality of life and reduce symptoms by restoring anatomy and function. PURPOSE: This study assesses the effectiveness of sacrohysteropexy by evaluation of intra-operative and post-operative complications and recurrence rates. METHODS: This study involved 18 women under 45 with stage 2 to stage 4 prolapse who underwent abdominal sacrohysteropexy at a tertiary care hospital. A comprehensive evaluation assessed surgical duration, complications, blood transfusion needs, and hospital stay length both pre- and post-surgery. Patients were monitored for 12 months after discharge to track recovery and any long-term effects or recurrence of prolapse. RESULTS: Age distribution: 7 aged 21-30, 10 patients aged 31-40, 1 over 40.All patients were married. Parity: 1 was nulliparous, 13 patients had 1-3 children and 4 had 4-6 children. Prolapse stage : 2 patients each had stage 2 and stage 4 had whereas 14 patients had stage 3 while.Blood loss: 1 case required transfusion (500 ml). Mean Surgery duration: 60-90 mins on. Complications: 1 case of wound dehiscence. Discharge: Average duration of hospital stays was 5-7 days. Follow-up: Mean 12 months. no mesh erosion or recurrence detected. Deep dyspareunia: Reported in 1 patient during follow-up. Success rate: (100%). CONCLUSION: Abdominal Sacrohysteropexy is a safe and effective treatment option for women suffering from uterovaginal prolapse with willingness to preserve the menstrual and reproductive functions.
Does Hypoglycemia During 50-g Glucose Challenge Test Adversely Affect Perinatal Outcomes?
Reis YA, Aksan A, Firatligil FB … +3 more , Akay A, Karadeniz RS, Ustun Y
J Obstet Gynaecol India · 2026 Jun · PMID 42369254 · Full text
BACKGROUND/PURPOSE: This study aims to assess maternal and neonatal outcomes in pregnancies complicated by hypoglycemia during the 50-g oral glucose challenge test (GCT). METHODS: This is a retrospective cohort analysis...
BACKGROUND/PURPOSE: This study aims to assess maternal and neonatal outcomes in pregnancies complicated by hypoglycemia during the 50-g oral glucose challenge test (GCT). METHODS: This is a retrospective cohort analysis of all live births at a single medical center between 2015 and 2019 with available 50-g GCT results and birth outcomes. Hypoglycemia during 50-g GCT was defined as a glucose value below 88 mg/dl at the first-hour glucose result. Maternal characteristics and perinatal outcomes were compared between two groups: hypoglycemia at 50-g GCT (group 1) and normal 50-g GCT (group 2). RESULTS: A total of 535 nulliparous cases were included. No significant differences were observed in delivery week and day, Apgar scores at 1 and 5 min, mode of delivery, fetal sex, and admission to the neonatal intensive care unit ( > 0.05). While no significant differences were found in prenatal biparietal diameter, abdominal circumference, and femur length ( value, 0.486, 0.297, and 0.106, respectively), birth weight was significantly lower in the hypoglycemic group (3222 ± 566 vs. 3340 ± 410, < 0.001). CONCLUSION: Hypoglycemia during a 50-g GCT is significantly associated with lower birth weight. Pregnant women experiencing hypoglycemia during the 50-g GCT at 24-28 weeks' gestation should be closely monitored, possibly classified as high-risk pregnancies, considering the potential for unfavorable perinatal outcomes.
A Comparative Analysis of Fertility-Sparing Surgery and Complete Staging Surgery in Early Stage Epithelial Ovarian Cancer: Impact on Oncological Outcomes.
Briskala P, Thomas V, Sebastian A … +6 more , Karuppusami R, Thomas DS, Singh A, Daniel S, Chandy R, Thomas A
J Obstet Gynaecol India · 2026 Jun · PMID 42369253 · Full text
BACKGROUND: Fertility-sparing surgery (FS) is a viable option for women with early-stage epithelial ovarian cancer (EOC) desiring fertility preservation. However, its oncological outcomes remain debated. METHODS: This re...
BACKGROUND: Fertility-sparing surgery (FS) is a viable option for women with early-stage epithelial ovarian cancer (EOC) desiring fertility preservation. However, its oncological outcomes remain debated. METHODS: This retrospective cohort study analysed 135 patients with FIGO (International Federation of Gynaecology and Obstetrics) stage I EOC, operated between 1st January 2011 and 31st December 2020, comparing clinicopathological characteristics and oncologic outcomes between women who underwent FS ( = 26) and comprehensive staging surgery (CS) ( = 109). Continuous variables were compared using a -test and Mann-Whitney test, while categorical variables were compared using the Chi-Square test. Disease-free and overall survival were plotted using Kaplan-Meier curves and compared using a log-rank test. RESULTS: During this period, Stage I EOC constituted 13.9% of the patients with EOC who underwent surgery. Patients in the FS group were younger (mean age 28.6 years versus 43 years, = 0.00), with higher rates of nulliparity (77% versus 15%, = 0.00). Though the pathological profile of the tumours in both groups was similar, 12(46%) in the FS group had high-grade histology. The FS group had a poorer follow-up rate (70% versus 83%, = 0.033), a higher recurrence rate (30% vs. 8%, = 0.001), and shorter mean disease-free survival (84.78 months vs. 124.86 months, = 0.002). Older age and FS were significant predictors of recurrence at 2 and 5 years. CONCLUSION: This study suggests that FS may be associated with higher recurrence rates in early-stage EOC. Careful patient selection, precise surgical information, and thorough follow-up protocols are crucial to balancing oncological safety with reproductive goals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13224-025-02239-w.
Bereavement Care After Stillbirth in Uttar Pradesh: A Qualitative Analysis of the Present Situation, Challenges, and Solutions.
Ahmad A, Nishad S, Gupta U … +1 more , Gupta NK
J Obstet Gynaecol India · 2026 Jun · PMID 42369252 · Full text
BACKGROUND: Bereavement care plays a crucial role in reducing the stress response in mothers who experience stillbirth. However, in India, the delivery of such care remains unregulated and inconsistent and lacks clear pr...
BACKGROUND: Bereavement care plays a crucial role in reducing the stress response in mothers who experience stillbirth. However, in India, the delivery of such care remains unregulated and inconsistent and lacks clear protocols and standards. The significant unmet need for bereavement care leads to dissatisfaction among both grieving mothers and caregivers. This study was conducted to assess existing bereavement care practices following stillbirth, identify the challenges faced by healthcare providers, and suggest possible solutions. METHODS: The present study is a qualitative analysis using the medium of in-depth interviews. We used a semi-structured, validated questionnaire and audio-video recording of the interviews. The questions pertained to the existing practices, awareness, challenges faced by healthcare providers and suggestions for improvement at micro- and macrolevel. RESULTS: Using purposive sampling, we conducted 31 in-depth interviews of doctors and nursing staff involved in caring for women with stillbirth. Most of the subjects demonstrated lack of bereavement care awareness, discomfort in caring due to professional inexperience and the absence of training. There is no provision for care and counseling of healthcare providers who themselves undergo psychological trauma and mental stress when caring for such women. CONCLUSION: Bereavement care after stillbirth is in its primitive stages in most of the care settings in India. Increasing awareness about stillbirth and bereavement care, making guidelines, conducting mandatory training for healthcare providers, and introducing "Bereavement companionship" model as a pilot project can provide initial steps toward betterment in care.
Proteinuric and Non-proteinuric Pre-eclampsia: A Comparative Analysis of Risk Factor Profile, Clinical Picture, Laboratory Parameters and Pregnancy Outcome.
Bhavya YS, Jena P, Voola S … +3 more , Panda B, Prasanna G, Panda J
J Obstet Gynaecol India · 2026 Jun · PMID 42369251 · Full text
BACKGROUND: Pre-eclampsia, a hypertensive disorder of pregnancy remains a challenge worldwide despite advance in the medical science and research due to its adverse impact on pregnancy. OBJECTIVES: To compare the clinica...
BACKGROUND: Pre-eclampsia, a hypertensive disorder of pregnancy remains a challenge worldwide despite advance in the medical science and research due to its adverse impact on pregnancy. OBJECTIVES: To compare the clinical characteristics, sociodemographic risk factors and the pregnancy outcomes between proteinuric and non-proteinuric pre-eclampsia incorporating the revised definition. METHODOLOGY: A prospective observational study consisting of 147 case of pre-eclampsia as per ISSHP-2018 diagnostic criteria of which 91 (63.6%) with proteinuria and 52 (36.4%) were without proteinuria. The maternal characteristics and pregnancy outcome were studied in both the groups and analyzed using appropriate statistical method. RESULTS: Use of revised definition lead to 1.5% increase in the incidence of pre-eclampsia (PE). A significantly higher proportion of non-proteinuric PE were ≤ 30 years as compared to proteinuric PE (78.8% vs. 61.5%, value: 0.033). The proteinuric PE had significantly higher mean systolic and mean arterial pressure ( value: 0.011), higher association with clinically severe disease ( value: 0.008), higher values of serum creatinine ( value: 0.024) and serum LDH levels ( value: 0.004), higher rate of growth retarded fetus ( value: 0.029), low birth weight ( value: 0.014) and peri-natal mortality ( value: 0.018) as compared to non-proteinuric PE. However, the binary logistic regression analysis failed to demonstrate any significant difference between the two groups in any of the maternal characteristics or pregnancy outcome measures. CONCLUSION: PE with or without proteinuria can be equally severe compromising the pregnancy outcome and hence demands for increase supervision and monitoring once diagnosis of PE is established.
Prenatal Attachment Inventory: Adaptation and Validation in the Indian Context.
Rajitha K, Verma MK, Mohan VA
J Obstet Gynaecol India · 2026 Jun · PMID 42369250 · Full text
BACKGROUND: This study aimed to translate and validate the Prenatal Attachment Inventory (PAI) into Malayalam to address a gap in Maternal-Fetal Attachment (MFA) research in India. The PAI was adapted based on John Bowlb...
BACKGROUND: This study aimed to translate and validate the Prenatal Attachment Inventory (PAI) into Malayalam to address a gap in Maternal-Fetal Attachment (MFA) research in India. The PAI was adapted based on John Bowlby's attachment theory and Mecca Cranley's Maternal-Fetal Attachment Scale (MFAS), incorporating expert feedback to reflect Indian cultural contexts better. METHODS: The translated PAI was administered to 250 pregnant women in Kerala. The translation process included adding three new items focused on maternal self-care, activities with the fetus, and resource usage, categorized as "personal reflection." These additions, alongside original factors of anticipation, differentiation, and interaction, were validated by reviewers, resulting in a Content Validity Ratio of 0.95. RESULTS: Initial Confirmatory Factor Analysis indicated a Comparative Fit Index (CFI) of 0.821, Tucker-Lewis Index (TLI) of 0.791, Standardized Root Mean Square Residual (SRMR) of 0.0631, and Root Mean Square Error of Approximation (RMSEA) of 0.0764. After removing four low-loading items, the revised model showed improved fit indices: CFI of 0.843, TLI of 0.811, SRMR of 0.0591, and RMSEA of 0.0802, with Akaike Information Criterion and Bayesian Information Criterion values decreasing to 9823 and 10,024. CONCLUSION: The Cronbach's alpha of 0.868 for the Malayalam PAI demonstrated strong internal consistency. This validated tool provides a reliable and culturally appropriate measure for MFA in India, supporting future research and interventions to enhance maternal and fetal health outcomes.
Topical tranexamic acid on episiotomy site for reducing postpartum hemorrhage: a double-blinded controlled trial.
Fakehi M, Pestehe M, Shirdel S … +6 more , Rafieirad P, Sheli S, Ghaffari F, Khanmohammad R, Ghaemi M, Mazloomi M
J Obstet Gynaecol India · 2026 Apr · PMID 42145936 · Full text
OBJECTIVE: Episiotomy is a common obstetric procedure that can facilitate vaginal delivery. Despite its widespread use, it can cause complications such as an increase in postpartum hemorrhage, wound infection, and dehisc...
OBJECTIVE: Episiotomy is a common obstetric procedure that can facilitate vaginal delivery. Despite its widespread use, it can cause complications such as an increase in postpartum hemorrhage, wound infection, and dehiscence. While tranexamic acid (TXA) has been shown to reduce surgical site bleeding and postpartum hemorrhage, the effect of topical TXA application on decreasing episiotomy bleeding remains unexplored. This study aims to evaluate the efficacy of topical TXA in reducing postpartum bleeding. METHOD: This double-blinded, controlled trial was conducted among 100 nulliparous pregnant women undergoing vaginal delivery. Participants were randomly divided into an intervention group, which received 1 g of TXA in 20 cc of normal saline topically on the episiotomy site, or a control group, which received 20 cc of normal saline as a placebo. Outcomes were measured based on changes in heart rate, systolic blood pressure, diastolic blood pressure, hemoglobin and hematocrit levels, postpartum hemorrhage, and wound healing complications, with the aim of comparing the amount of postpartum bleeding. RESULT: There were no statistically significant differences between topical TXA and placebo recipients regarding maternal and pregnancy variables, including age, body mass index, gestational age, newborn weight, use of vacuum assistance, augmentation of labor, medical conditions, postpartum bleeding, changes in heart rate, blood pressure, hemoglobin and hematocrit levels, episiotomy site infection, and wound dehiscence. CONCLUSION: The topical application of TXA on the episiotomy site did not significantly reduce postpartum bleeding. Further studies with larger sample sizes and higher doses may provide more conclusive results.
A Comparative Study Between the Diagnostic Accuracy of IOTA Simple Rules and Risk Malignanct Index (RMI) in Differentiating Malignant from Benign Adnexal Masses.
Nandhana V, Raja Rajeswari KS, Sadhana K
J Obstet Gynaecol India · 2026 Apr · PMID 42145935 · Full text
BACKGROUND: Of all the gynecologic cancers, ovarian cancer has the greatest clinical challenge. It is often asymptomatic at an earlier stage and many of them present in an advanced stage for which the five-year survival...
BACKGROUND: Of all the gynecologic cancers, ovarian cancer has the greatest clinical challenge. It is often asymptomatic at an earlier stage and many of them present in an advanced stage for which the five-year survival rate remains low. However, the major hurdle faced by gynecologists is in diagnosing the disease early, owing to the fact that ovarian malignancies do not manifest clinically until a later stage. PURPOSE OF THE STUDY: As the most important prognostic factor is the quality of primary cytoreductive surgery, a high degree of suspicion and multi-diagnostic approach is required in patients with nonspecific symptoms in the high-risk age group, to detect the malignancy at its earliest. There are only few studies on classification systems to categorize ovarian mass into benign and malignant pre-operatively and to decide upon proper management and counseling of the patient. METHODOLOGY: In this study we assessed "the accuracy of International Ovarian Tumor Analysis (IOTA) simple rules with Risk Malignancy Index (RMI) to differentiate benign from malignant adnexal mass". By evaluating the performance of each classification system, we analyzed the nature of an adnexal mass pre-operatively based on its score and hence decide upon the treatment modality. A total of 49 patients were enrolled in the study and were followed up by menopausal status, ultrasonogram and serum tumour markers. RESULTS: When compared to HPE, RMI had sensitivity of 71.43% (95% CI 29.04-96.33%), Specificity was 97.62% (95% CI 87.43-99.94%), False positive rate was 2.38% (95% CI 0.06-12.57%), False negative rate was 28.57% (95% CI 3.67-70.96%), Positive predictive value was 83.33% (95% CI 35.88-99.58%), Negative predictive value was 95.35% (95% CI 84.19-99.43%) and Diagnostic accuracy was 93.88% (95% CI 83.13-98.72%) When compared to HPE, IOTA had a sensitivity of 100.00% (95% CI 2.50-100.00%), Specificity of 94.59% (95% CI 81.81-99.34%), False positive rate of 5.41% (95% CI 0.66-18.19%), False negative rate of 0.00% (95% CI - to 97.50%), Positive predictive value of 33.33% (95% CI 0.84-90.57%), Negative predictive value of 100.00% (95% CI 90.00-100.00%), and the Diagnostic accuracy was 94.74% (95% CI 82.25-99.36%). CONCLUSION: The diagnostic accuracy of the IOTA is better than RMI in our cohort study, which is synchronous. Though the diagnostic accuracy of RMI is found to be fairly good in our study population, it has misdiagnosed 4% of patients as benign when HPE was suggestive of Malignancy which majorly questions its role as a tool for pre-operative evaluation. Subjective assessment by an experienced sonographer combined with the use of serum tumour markers currently seems to be the most effective method to preoperatively characterize ovarian tumors.
Successful Pregnancy and Childbirth Decades After Renal Transplant.
Jacob VA, Jiby S, Abraham G … +1 more , Mathew M
J Obstet Gynaecol India · 2026 Apr · PMID 42145934 · Full text
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A Feasibility Study on the Effect of a 12-Week Pelvic Floor and Core Training on Pain, Muscle Strength and Thickness in Women with Chronic Non-specific Low Back Pain.
Thuramalla M, Aseer Peter AL, Nallamalla KR … +3 more , Balasubramanian S, Rao M, Palakamsetti S
J Obstet Gynaecol India · 2026 Apr · PMID 42145933 · Full text
BACKGROUND: Combining training for the pelvic floor muscle (PFM) with core stability exercises have unique advantages for treating Chronic Non-specific Low back pain (CNSLBP).Given the significant role of PFM in lumbar s...
BACKGROUND: Combining training for the pelvic floor muscle (PFM) with core stability exercises have unique advantages for treating Chronic Non-specific Low back pain (CNSLBP).Given the significant role of PFM in lumbar spine stability and the suggested link between lumbar instability and Low Back Pain in women, it was hypothesized that PFM exercises could provide beneficial outcomes for patients with CNSLBP Objective: To evaluate the effect of a 12 week Pelvic floor muscle and core training program in women with CNSLBP. METHODS: A total of 70 women with CNSLBP (20-40 years) participated in the study. They were randomly allocated into 2 groups. Group A received PFM Exercises combined with Core stabilization exercises, and Group B received core stabilization exercises alone for 12 successive weeks. Pain intensity, Muscle strength (transverse abdominis (TrA) and pelvic floor muscles (PFM)), and thickness (TrA and PFM) were measured before and after treatment program. STATISTICAL ANALYSIS: There was no difference between the groups in terms of age, BMI, number of births and mode of delivery ( > 0.05) and also in all clinical parameters ( < 0.05)p more than 0.05 between the groups at the baseline. Independent and paired -tests were used. RESULTS: Post-intervention analysis revealed significant differences between the two groups in pain, strength, and muscle thickness, favouring the interventional group ( < 0.05). DISCUSSION: The current study assessed the efficacy of the intervention on several key outcomes, including pain, muscle strength (TrA and PFM), and muscle thickness (TrA and PFM). The intervention group demonstrated notable enhancements in pain, muscle strength and thickness, suggesting a positive impact of the intervention on muscular outcomes.
Carcinoma Hypopharynx in Pregnancy: A Multidisciplinary Team Triumph.
Thomas S, Kusuma M, Ahmed M … +3 more , Tarakeswari S, Hemamalini V, Pandya ST
J Obstet Gynaecol India · 2026 Apr · PMID 42145932 · Full text
Cancer complicates approximately 0.1% of all pregnancies. The incidence of cancer in pregnancy has increased, as many women are planning pregnancies at an older age. Cancers of breast, melanoma, hematologic, cervix/uteru...
Cancer complicates approximately 0.1% of all pregnancies. The incidence of cancer in pregnancy has increased, as many women are planning pregnancies at an older age. Cancers of breast, melanoma, hematologic, cervix/uterus and thyroid are the more common invasive cancers diagnosed in pregnancy. Head and neck cancers during pregnancy are uncommon. Also the symptoms are non-specific and commonly mimic the usual pregnancy symptoms such as hyperemesis and so tend to be missed. The management of head and neck cancers during pregnancy necessitates a deeper understanding of the effects of pregnancy on cancer and vice versa, and the effect of diagnostic and treatment modalities on pregnancy. A multidisciplinary approach is needed to enable parents and clinicians to make the best clinical decision. We present one such case of this rare carcinoma in pregnancy which presented with hyperemesis. A detailed workup revealed carcinoma hypopharynx which was successfully managed with a multidisciplinary team effort. Through this case, we want to emphasize the need to have a high index of suspicion for atypical symptoms in pregnancy and a low threshold for further investigations. Early diagnosis and appropriate management will result in positive maternal and fetal outcomes.
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