Indian Journal of Obstetrics and Gynecology

Cervical fibroids constitute only 1- 2% of all fibroid. Large massive submucous cervical fibroid may pose a surgical difficulty due to distorted anatomy. Upword displacement of uterus leads to impaction of fibroid. Combined vaginal and abdominal approach may be required in such cases. 

Keywords: Cervical fibroid; Hysterectomy. 

Use of levonorgestrel as emergency contraception is a safe and effective measure to prevent unwanted pregnancy. Limited data have been available on the effect of the pregnancy outcomes and there have been no reports on adverse birth outcomes, but only a small number of normal deliveries after levonorgestrel emergency contraception (LNG– EC) failure have actually been documented. We present a case of pregnancy following failure of levonorgestrel emergency contraception. The pregnancy was terminated as the fetus was affected by a lethal condition, sirenomelia or mermaid syndrome. Although LNG–EC taken during the conception cycle has no significant effects on the incidence of malformation, however the number of investigated pregnancies is relatively small, and these findings need to be further assessed in the context of larger groups including those are that are chosen to be aborted.    

Keyword: Levonorgestrel; Emergency contraception failure; Sirenomelia; LNG- C.

Fertility sparing in gynecological malignancies; what was impossible or the dream of yesterday, is the hope of today and the reality of tomorrow. Motherhood is dream of every woman. When engulfed by monster of cancer,it is saddest aspect of their life. The intuitive fertility sparing options are the sacred gifts for these shattered lives. Preservation of fertility has recently become a very important objective in gynecological oncology. Oncological advances with the paragons of objectivity, a clear decision-making process, adequate counseling about the future oncological and obstetrical risks and benefits, appropriate management, and careful follow-up within a multidisciplinary approach provides beam of hope to these women. Given the increases in 5-year cancer survival and recent advances in fertility preserving technologies, an increasing number of women with cancer are presenting for discussion of fertility preserving options [1]. This applies particularly for women who develop gynecological malignancy during their childbearing years where curative treatment also renders them infertile[2]. This study reviews the increasing role of fertility-sparing modalities in such women with cervical, endometrial and ovarian cancer. Fertility preserving methods have psychological, ethical and legal aspects that should be fully discussed.

Keywords: Fertility sparing; Cervical Cancer; Endometrial cancer; Ovarian cancer; Ethical issue. 

Pregnancy is commonly associated with faulty posture, pedal edema, pelvic floor stresses, changing body image and various musculoskeletal pathologies . Exercise has a beneficial role in improving the general well being . However, adjustments has to be made to the normal exercise routine according to the changing demands of the mother’s body. Exercise plan greatly depends upon various conditions associated with pregnancy, relative and absolute contraindications. Therefore, the level of the exercises is to be strictly recommended by a Physiotherapist in consultation with Obstetrician. Thereby, the purpose of this article is to discuss the goals, guidelines, types, intensity and frequency of the exercises during pregnancy and post partum period.  

Keywords : Pregnancy ; Physiotherapy; Exercise; Indications; Absolute and Relative Contraindications; Goals; Guidelines; High Risk Pregnancy; Post partum period; Cesarean. 

PCOS is the most common cause of anovulatory infertility. Life style changes is the first line treatment in management of PCOS. Even 5-10% weight loss has significant clinical benefits. Obesity is associated even with long-term metabolic outcome in children. Weight loss should be advised prior to conception. First choice of ovulation induction is clomiphene citrate (CC) use of metformin in PCOS should be restricted to the patients with glucose intolerance. Gonadotrophin with starting dose of 37.5-50 IU/day should be used in CC failure situation. Laparoscopic ovarian surgery (LOS) s preferred in CC resistant cases with persistently hypersecretion of LH. It can be alternative to gonadotrophin for CC resistant PCOS cases. Repeated LOS should not be encouraged. In >50% of LOS treated adjuvant treatment may be required. Addition therapy with CC can be instituted after 12 weeks and gonadotrophines may be considered after 6 weeks. After failure of all modalities IVF may be offered.  

Key words: Infertility; Induction of ovulation. 

Estimation of gestational age is one of the corner stone of prenatal care. Preterm birth rates are higher in developing countries. Women presenting late in pregnancy poses a great problem in assessing gestational age, even USG may not provide correct estimation. Amniotic fluid near term contains an increased amount of surfactant protein. It accelerates the clotting if added to the blood. Accelerated clotting time (aACT) in amniotic fluid is a simple easy bedside test especially for unreported cases admitted with uncertain gestational length.   

Key words: Amniotic fluid; Clotting time; Preterm. 

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