Indian Journal of Obstetrics and Gynecology Research

127-131

Authors: Ravinder Pal Singh, Megha Pravin Khobragade, Anil Kumar, Achhelal Ramashankar Pasi

Background: decreasing sex ratio is an issue of major concern in India and has long-term social and demographic consequences. A community based cross-sectional study was conducted to explore the reasons and perceptions of people regarding decreasing sex ratio and gender inequalities. Objectives: to assess the knowledge, attitude and practices regarding gender preference, gender inequality and female infanticide. Material and Methods: study was conducted in 30 villages of Kathua district of Jammu & Kashmir. Study participants were eligible couples of the selected villages. Villages and study participants were selected by systematic random sampling. Data on knowledge, attitude and practice was collected using a standard questionnaire. Results: out of 300 couples 30% were illiterate. Overall 70% & 66% of the couples were aware of the decreasing sex ratio & its social consequences respectively. Though 75% of the respondents knew that sex determination is a crime, 17% reported that they would go for prenatal determination of sex and 11% of women were in favor of doing female feticide. A total of 79% couples reported preference for son. Antenatal USG was conducted in 60% of pregnancies, 61% of women reported to have experienced family pressure for son and 31% sought divine intervention to have son. Conclusion: over all study population had good knowledge of declining sex ratio, its social consequences and illegality of prenatal sex determination including female infanticide. Prenatal sex determination and female feticide was not preferred by majority of the study population. Most of the couples had perceived preference for son and majority had faced family pressure for the same. Recommendations: strengthening the ongoing IEC and BCC activities to promote gender equalities in the rural part of northern India. Implementation of policies & programs for overall development of girls. Keywords: sex determination, gender preference, gender inequalities, female infanticide, Jammu & Kashmir

137-148

Authors: K.Ramalingam, Devisrimurari, Mounica. Bollu, Shaik. Faizan Ali

Background: Gestational diabetes is associated with significant metabolic alterations, increased maternal and perinatal morbidity and mortality. Indians fall into high risk ethnic group for diabetes mellitus. Objectives: The objective of this study is early detection and treatment of gestational diabetes mellitus(GDM) in pregnant women and to assess perinatal outcome in a well controlled and poorly controlled gestational diabetes mellitus patients. Materials and Methods: Sample: All pregnant women attending to outpatient department in obstetrics and gynaecology department at NRI medical college hospital in Chinakakani Guntur(Dt) universally screened for GDM in all three trimesters. Methods: single step oral glucose tolerance test(OGTT) with 75 grams glucose. This test is performed by asking the patient to come with overnight fasting. after collecting fasting venous sample from patient, solution made of 75 grams glucose mixed with 150 ml water is given. patients with fasting plasma glucose value ≥90 mg/dl and 2nd hour plasma glucose value≥140mg/dl are diagnosed to have gestational diabetes. Results: Out of 71 pregnant women diagnosed as GDM, the commonest risk factors are age≥25 years(61.9%),followed by past history of abortion(33.8%), obesity(32.39%), overweight(32.39%), past history of GDM(16.9%), family history of diabetes to mother(22.5%),father(19.7%),both parents(4.2%). 9.8% of GDM patients were diagnosed ≤ 12 weeks, 61.9% between 13-28 weeks,22.5% between 29-34 weeks and 5.6%≥35 weeks. OGTT was carried out in all three trimesters for all antenatal women, so that GDM cases diagnosed in late weeks of gestation are not missed.GDM patients were followed up with 75 grams OGTT after 6 weeks, and 16.9% of women were positive for the test. Conclusion: Single step OGTT with 75 grams glucose with cut-off values of fasting plasma sugar≥90mg/dl and 2nd hour plasma sugar≥140 mg/dl is very useful in diagnosing GDM. Universal screening for GDM is superior to selective screening(based on risk factors) for detecting more cases, facilitating early diagnosis and treatment of a disorder that carries an adverse prognosis in antenatal women with no symptoms of GDM. The criteria recommended by WHO are simple and cost effective and it is practised in many centres. Further assuming that effective treatment is available, WHO criteria of 2nd hour plasma sugar levels≥140mg is useful in identifying a large number of cases and may have greater potential for prevention.one step procedure of WHO serves dual purpose for screening and diagnosis

155-158

Authors: Savita Rani Singhal, Veenu Kadian2, Sunita Singh, Veena Singh Ghalaut

Background: To compare the efficacy and side effects of ferrous sulphate, fumarate, ascorbate, sodium feredetate and ferrous bisglycinate in the treatment of iron deficiency anemia in pregnancy. Material and methods: The study is a prospective, randomized, comparative clinical study comprising of 250 antenatal women with hemoglobin between 7-10 gm %. The patients divided into five groups I, II,III,IV and IV of fifty each, by systematic randomization and were treated with ferrous sulphate (100mg), ferrous fumarate (100mg), ferrous ascorbate (100mg), ferrous bisglycinate (30 mg), sodium feredetate (33 mg) respectively. Hemoglobin estimation was done at day 0, 30 and 60 and serum ferritin levels were done on day 0 and 60. Results: There was significant and comparable rise in hemoglobin on day 30 and day 60 in all the five groups (p<0.001). Ferrous ascorbate and ferrous bisglycinate showed significantly (p<0.05) more rise as compared to ferrous sulphate. Maximum side effects were with ferrous fumarate (51) followed by ferrous sulphate (40), ferrous bisgylycinate (26), ascorbate (18) and sodium feredetate (10). Conclusion: Ferrous ascorbate and bisglycinate are more effective than ferrous sulphate in treatment of iron deficiency anemia in pregnancy. Sodium feredetate had minimum side effects. Keywords: Ferrous ascorbate, Ferrous bisglycinate, Ferrous fumarate, Ferrous sulphate, Sodium feredetate, Anemia, Pregnancy

163-168

Authors: Mital Joshi, Sirimavo Nair

Objective: The study was designed to determine the prevalence of menopausal symptoms during menopausal transition in middle age (30-60 years) women in Vadodara (N=1000). Method: They were interviewed by means of standard Menopause Rating Scale questionnaire (MRS) to report on the menopausal symptoms which were divided into somatic, psychological and urog. A predesigned questionnaire was used to assess their knowledge associated with menopause along with self-reported health profile. Results: The mean age of the study population was 42 + 5.1; where mean age of premenopausal group was 40.07 + 3.79, peri menopausal group was 41.72 + 4.28 and post-menopausal group was 46.4 + 5.32. The women reported pain in hands or legs as the most prevalent symptom (73.6%), followed by anxiety (67.4%), physical and mental exhaustion (66.8%). Other symptoms like dryness of vagina (48.5%), heart discomfort (45%), mood swings (35.5%) and irritability (32.8%) were reported by nearly half of the population. Severity of symptoms were observed for anxiety (2.7%), heart discomfort (2.3%), sleep disturbances (2.3%), bladder problems (2.1%). The mean total MRS was found to be rising up during transition from premenopause (4.60 + 3.07) to perimenopause (6.53 + 3.93) and showed a decline during transition from perimenopause to postmenopause (5.78 + 3.03). Amongst the three subscales of MRS, the mean of the Psychological domain (2.59 + 1.91) was higher followed by somatic symptoms (2.03 + 1.54) and least by the urogenital symptoms (0.92 + 0.99). A similar trend was observed during all stages of reproductive life, i.e. premenopausal, perimenopausal or postmenopausal (p<0.001) in these subjects. Knowledge of participants regarding the menopause and related health issues was very poor. Conclusion: The study concluded that, the time span between different menopausal transitions are very short and clashes with the time when a woman is already barring the highest degree of family responsibilities in her life. Therefore this raises a call for measuring and improving health- related quality of life of women during transition stages

174-175

Authors: Kartikey R. Shastri, Nalini I. Anand, Bhakti M. Ganatra

Obstetrics & Gynaecology is the medical and surgical specialty that focuses on the research prospectus of reproductive system in females.Indian Journal of Obstetrics and Gynaecology Research is a peer-reviewed journal that publishes articles on all aspects of basic and clinical research in the fields of obstetrics and gynaecology and related subjects, with emphasis on matters of worldwide interest. The journal publishes invited and submitted reviews and original articles about clinical topics and basic research; case reports; and preliminary communications from all sub-specialties in gynaecology and obstetrics. IJOGR publishes original research work in all relevant areas of reproduction, contraception, obstetrics and gynaecology that include reproductive endocrinology, reproductive physiology, assisted reproductive technologies, cloning, environmental effects on reproductive health, infertility, family planning, sexual health, obstetrics, prenatal diagnosis, maternal-fetal medicine, midwifery, perinatology, gynecological urology, gynecological oncology, gynecological endocrinology, general gynaecology and menopause.

179-184

Authors: Rakhee R Sahu, Anjali Sonawane

Obstetrics & Gynaecology is the medical and surgical specialty that focuses on the research prospectus of reproductive system in females.Indian Journal of Obstetrics and Gynaecology Research is a peer-reviewed journal that publishes articles on all aspects of basic and clinical research in the fields of obstetrics and gynaecology and related subjects, with emphasis on matters of worldwide interest. The journal publishes invited and submitted reviews and original articles about clinical topics and basic research; case reports; and preliminary communications from all sub-specialties in gynaecology and obstetrics. IJOGR publishes original research work in all relevant areas of reproduction, contraception, obstetrics and gynaecology that include reproductive endocrinology, reproductive physiology, assisted reproductive technologies, cloning, environmental effects on reproductive health, infertility, family planning, sexual health, obstetrics, prenatal diagnosis, maternal-fetal medicine, midwifery, perinatology, gynecological urology, gynecological oncology, gynecological endocrinology, general gynaecology and menopause.

188-190

Authors: Gangadhara Rao Koneru, Rekha Prabhu, Hema Gayatrhi A, Haritha P, Prabha Devi Kodey

Psoas Abscess is a rare association with pregnancy. A 24 years old primi gravida with term pregnancy presented with PROM, oligo hydramnios, fever, tachycardia and inability to move both lower limbs. On examination, membranes were intact, there was bleeding PV with excess vaginal discharge. There was foetal tachycardia (180/min). To exclude abruptio ultrasound was done. Intra Uterine Death was diagnosed. That time patient was in early labour which was accelerated with syntocinon. Suddenly she became hypoxic and was ventilated. She delivered a stillborn baby. In the puerperial period patient suffered fever for more than a month. As fever was not controlled for long period (one month) CT was done which showed hypodense areas in right psoas muscle. CT guided Percutenous drainage was failed. By MRI investigation, it was diagnosed as multiple abscesses with sacro illitis and was drained extra peritoneally. As fever is not controlled with broad spectrum antibiotics, montox skin was done which was strongly positive. Hence treatment with anti tuberculosis drugs was planned. Finally fever was controlled by antituberculosis drugs ISONIAZID 300 mg/day, REFAMYCIN 600 mg/day, ETHAMBUTOL 800mg/day, Inj. STREPTOMYCIN 1 gm/day as a thereuptic trail.

198-201

Authors: Joylene D’Almeida, Prashanth Hegde, Sujaya V Rao

Cervical ectopic pregnancy is defined as the implantation of an ectopic pregnancy in the cervix. The actual incidence is < 1%. Though rare, it requires a strong degree of clinical suspicion combined with ultrasound evidence to arrive at the diagnosis. The management of a cervical ectopic includes medical and surgical options. Medical options include using durgs like methotrexate and etoposide. Surgical options primarily include curettage and tamponade. Hemorrhage is a dreaded complication of a cervical ectopic and a torrential haemorrhage warrants an emergency hysterectomy.