Indian Journal of Obstetrics and Gynecology Research

59-61

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

Objectives: This study was carried out to study the incidence of DIC in various obstetric conditions and to study the role of component therapy and its effects on the deranged coagulation profile and maternal outcome in patients with deranged coagulation profile. Materials and Methods: An observational retrospective study design was selected for this study. A total of 100 cases that had presented to labour room of our hospital between January 2013 and January 2014 with deranged coagulation profile were studied for improvement in maternal outcome after giving component therapy. All the antenatal women admitted and having alteration in any of the following laboratory parameters were included in the study (Hb, Platelet, PT, INR, aPTT, Sr. fibrinogen). Patients having jaundice due to obstetric condition (excluding any infective etiology like hepatitis or other hepatic conditions) were included. Any patient having just altered hemoglobin suggestive of anemia and transfused with red cell concentrate for the same were excluded. Any patients with medical condition like ITP, SLE, and Dengue etc. that can alter coagulation profile were excluded. Results: 21 patients tested positive for D- dimer i.e. 21 patients had DIC among 100 patients with deranged coagulation profile during study period. Incidence of DIC in our study was 0.002%. Out of patients with DIC, 42.85% had IUFD, 42.85% severe pre-eclampsia, 30.49% abruptio placenta, 19.04% eclampsia and 14.28% had PPH. Incidence of DIC in PPH- 60%, abruptio placenta 23.07%, severe pre-eclampsia 23.07%, eclampsia 22.22% and 20.8% in IUFD.

65-68

Authors: Reema Sircar, Geetanjali Pawar

Objective: To determine the frequency, causes and outcome of liver disease in pregnant women. Setting: Tertiary care teaching hospital. Method(s): All pregnant women with liver disease attending the inpatient or outpatient services of the Department of Obstetrics and Gynecology over a period of 3 years were evaluated and followed up till delivery or death. Results: The study included 40 patients of Cholestatic jaundice, 38 patients of viral hepatitis, 15 patients of sepsis, 5 patients of HELLP syndrome and 1 patient each of hyperemesis gravidarum, amoebic abscess, enteric hepatitis & acute cholecystitis with pancreatitis. Intra hepatic cholestasis of pregnancy was the most common and least detrimental cause of liver disease in pregnancy. Number of preterm deliveries and incidence of LSCS was highest with HELLP Syndrome. ICU admissions were maximum with diagnosis of Hepatitis E and NICU admissions highest with HELLP Syndrome. Both HELLP Syndrome and Hepatitis E were responsible for maximum maternal and perinatal deaths. Conclusions: Liver disease in a pregnant woman needs to be treated with caution.

73-91

Authors: Manish R. Pandya, Dharmesh K. Golwala, Kalpana Khandheria

Background: To evaluate the clinical efficacy and safety effect of Ovaryl tablet a marketed herbal formulation of Mercury Laboratories Ltd., in Poly cystic Ovarian Syndrome. Methods: 58 women patients’ age range between 20 to 40 years, suffering from Poly cystic Ovarian Syndrome symptoms like hirsutism, irregular periods, ovulation, volume of ovary, weight and serum insulin levels. Results: A significant improvement was observed in clinical symptoms like hirsutism, irregular periods and ovulation after MOT medication.Laboratory investigation showed decrease in Serum Insulin levels. A minimum decrease of 2.87% and 36.73% maximum decrease of serum insulin levels were observed on 90th day of MOT treatment. 22.06% maximum and 1.55% minimum decrease of ovary volume in Right Ovary. 24.39% maximum and 1.37% minimum decrease of ovary volume in Left Ovary was observed. Upper Abdomen USG was normal in all the 58 patients, no cyst was reported. Conclusion: Poly cystic Ovarian Syndrome symptoms like hirsutism, irregular periods, ovulation, and volume of ovary, weight and serum insulin levels were taken care off.

97-100

Authors: Seema Sharma, Manju Maheshwari, Shubhra Gupta

Objective: To study the role of uterine artery notch on color Doppler ultrasound in prediction of PIH. Methods: This observational prospective longitudinal study was conducted in Department of Obstetrics and Gynaecology Mahatma Gandhi Medical College and Hospital, Jaipur. Study sample comprised of 100 antenatal patients with 20-28 weeks of gestation attending OPD of Department of Obstetrics and Gynaecology Mahatma Gandhi Medical College and Hospital, Jaipur from august 2013-14 and studied for the presence of Doppler changes during antenatal period. Results: The primary outcome was that uterine diastolic notch shows sensitivity 60%, specificity 100%, PPV 100 % and NPV 85.37% in predicting PIH. Conclusion: After analysing all the results, it has been concluded that uterine artery Doppler notching is good predictor for PIH.

103-107

Authors: Anushree. D. Patil, Sushil K Shinde, Geetanjali M. Sachdeva, Achhelal R. Pasi, Shanta M. Chitlange,

Introduction: Diagnosis of endometrial tuberculosis is often carried out by using commercially available molecular diagnostic tests on endometrial biopsy samples and menstrual blood samples of infertile women in many infertility clinics. Aim: To determine whether menstrual blood is a good alternative sample for diagnosis of endometrial tuberculosis. Methods: Women (n=123) presenting with infertility were investigated for endometrial tuberculosis by testing menstrual blood samples as well as endometrial aspirates with GEN-PROBE AMPLIFIED Mycobacterium Tuberculosis Direct (MTD) test which is a Nucleic Acid Amplification Test (NAAT) and VersaTREK culture. Results of the two tests for detection of M. Tuberculosis were compared in menstrual blood and endometrial aspirate samples. Results: Out of 123 menstrual blood samples tested M. tuberculosis was detected by culture in only 0.8 per cent of women. Mycobacterium other than Tuberculosis (MOTT) was detected in 2.43 per cent samples of menstrual blood on culture reports and was identified to be Mycobacterium inter medium. Conclusion: Menstrual blood was not found as a good alternative sample for diagnosis of endometrial tuberculosis. Results of MTD tests on menstrual blood sample for diagnosis and management of endometrial tuberculosis (as is widely used in infertility clinics) should be interpreted with caution. Pathological significance of Mycobacterium inter medium in female infertility, though a possible contaminant, needs further research.

117-119

Authors: Prashant Joshi, Linthoi Rajakumari

Intrauterine contraceptive device has been widely used and is commonly used as contraception in developing countries due to lower failure rate and the cheap cost with millions of women using it worldwide. The case report shows a missing Cu-T found in the abdominal cavity with its vertical stem penetrating into the rectum in a 20year old woman. Laparotomy with closure of rectal injury and uterine perforation with retrieval of the Cu-T was successfully done.

123-126

Authors: Mehul A Sangani, Manish R Pandya

The death of a formed fetus is one of the most emotionally devastating events for parents and clinicians. It is psychological and emotional shock to parents when they know that their baby has suddenly died in utero. Aims and Objectives: To know the causes of IUD and determine the risk factors and minimize the complications of IUD and maternal morbidity and mortality. Method: A prospective study was done to study 110 cases of IUD. On admission, patient's detailed history was taken, examination, investigations and ultrasonography was done and the case was managed accordingly. Results: A total 110 cases of IUD were studied over one year in our institute. Out of them 70 had not taken any antenatal visits, 96 patients were aged below 30 years, 11 patients were aged between 31 to 35 years and 3 patients above 35 years. 56 were primigravida, 40 were second gravida and 14 were multigravida. Of 28 cases causes were unknown, 18 cases had abruptions, 8 cases had PIH, 15 cases had preeclampsia, 11 cases had eclampsia, 12 had cord accidents, 3 had oligohydraminos, 2 had jaundice, 1 had rupture uterus and 8 patients had congenital anomaly. 28 patients delivered spontaneously, 75 delivered by induction of labor and 7 patients required caesarean section. 5 patients developed PPH and 7 patients developed DIC.