Indian Journal of Obstetrics and Gynecology

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Keywords: Gonadal dysgenesis; Mayer-Rokitansky-Kuster-Hauser syndrome; hypogonadism; Primary amenorrhea. 

 Pseudotumour Cerebri also called as benign intracranial hypertension is characterized by increased intracranial pressure, without a mass lesion and with elevated cerebrospinal fluid (CSF) pressure. Though its incidence in pregnancy is quite rare, the intractable headache associated and danger of impending visual loss warrants an early recognition, diagnosis and treatment.  The following is an antenatal presentation of benign or idiopathic intracranial hypertension or pseudotumour cerebri. 

Keywords: Ureteric Injury; Ureteric Stent; Vesicle Calculus. 

 Gastric cancers are very rare in pregnancy and are often undiagnosed due to lack of referral of symptomatic patients to speciality centres from the peripheral units. Though the general outcomes are poor, a favourable prognosis can be ensured with early diagnosis and curative therapy. All that is required is a strong clinical suspicion and a prompt endoscopic evaluation of gastric symptoms in pregnancy.

Keywords: Cystectomy; Veress needle; Laparotomy; Pneumoperitoneum 

 Extra Uterine fibroids are not common as uterine fibroids. They may arise from the broad ligament, uterosacral ligament, round ligament, vagina and vulva [1]. Among the extra uterine fibroids, broad ligament fibroids are the most common to occur with its overall incidence being 1% [2].  It possesses specific difficulty causing errors in making clinical diagnosis and offering management. This is one such case report where in clinical diagnosis of ovarian tumor was made and preoperative findings showed a huge fibroid found in the broad ligament on the right side with its attachment to the uterosacral ligament and histopathology confirmed the diagnosis of leiomyoma. 

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 Background and Objectives: Fetal weight is one of the greatest factors, determining the survival of the fetus. Ultrasound study presents a very important tool in modern day obstetrics. Accurate assessment of fetal weight is mandatory for obstetric management particularly at term. Present study is a prospective observational study comparing the fetal weight estimation by clinical method using Johnson’s formula and ultrasound method using Hadlock’s formula at term and its accuracy with the actual birth weight. Methods: Present study was a prospective observational study conducted in 300 term pregnant women. Expected fetal weight was estimated by measuring symphysio fundal height clinically using Johnson’s formula and ultrasonographically using Hadlock’s formula. Both the weights were compared with actual birth weight. Statistical test were done using student-t test and chi square test. Results: The mean birth weight of Hadlock’s formula, 2942.57 gms, was closest to mean of actual birth weight, 2958.01 when compared to Johnson’s formula mean birth weight 3046.95. The difference between mean birth weights of Hadlock’s and Johnson’s formula with actual birth weight being 15.433 gms and 88.947 gms respectively. The mean error and standard deviation from actual birth weight are least with Hadlock’s formula compared to Johnson’s formula. Conclusion: Birth weight is a key variable affecting fetal and neonatal morbidity, particularly in preterm and small for date babies. In addition, it is of value in the management of breech presentations, diabetes mellitus, trial of labour, macrosomic foetuses and multiple births. Of the two methods studied, ultrasonographic method, i.e., Hadlock’s formula has better predictable results in fetal weight estimation, compared tho clinical method, i.e., Johnson’s formula.

Keywords: Ultrasound, Hadlock’s formula, Johnson’s Formula, Symphysio Fundal Height, Actual Birth Weight.

 Introduction: Incidence of cervical cancer is still very high in India as compared to the western countries. It is the commonest genital malignancy and leading cause of women’s mortality. It is very unfortunate to see so many cervical cancer patients in India when there are preventive and screening methods available. The screening method is cheap but still not used as a national screening method in our country. The questionnaire survey was done to find out medical students’ knowledge about screening (Pap smear) and preventive (HPV vaccination) methods. They were also asked if they have been proactive in spreading this information far and wide. Methods:  Questionnaire survey was done of the final year and pre-final year medical students of Institute of Medical Sciences, Banaras Hindu University.  It was done in April and May 2015. There were total of 61 Final year Medical Students and 37 Pre-final year Medical Students (a total of 98 medical students). Results: Male students were 38 in final year and 17 in pre-final year. Female students were 23 in final year and 20 in pre-final year. Total number of male students was 55 and female students were 43. All students were unmarried. 89 students =90% (50 male and 39 female) knew cancer cervix and its predisposing factors. 77 students = 78% (38 male and 39 female) knew that HPV has a strong association in causation of this cancer. 54 students (55%) knew about the HPV Vaccine (42 female and 12 male). None of the female students had HPV vaccine. Male students were asked about their HPV vaccine intake and they thought it was a joke! Students were asked if they have explained to anyone in family or community regarding Pap smear or HPV vaccine, for which the reply was negative. 75 =76% (39 male and 36 female) students knew about Pap smear as a screening method. Conclusions: Students knowledge were  good about Pap smear and HPV vaccine but they need to be motivated to spread their information wide in the community. This is due to the very fact that incidence of cancer cervix is very high in our country and if we decide to make each and every medical student as a champion of it, it will do well to our society. 

 bhCG and lipid levels during second trimester of pregnancy are associated with the development of pregnancy induced hypertension (PIH). Methods: 100 pregnant women between 14-20 weeks gestation with singleton pregnancy irrespective of parity were selected randomly and serum bhCG and lipid profile were estimated by chemiluminescent immunometric assay (CLIA ) and enzymatic colorimetric test respectively. Regular follow up of the cases was done till delivery. Results were analyzed statistically. Results: Out of 93 cases followed up till delivery, 10 cases developed PIH. Serum bhCG (median ³ 35000 mIU/dl) has sensitivity of 80%, specificity of 59% and accuracy of 61%. Dyslipidemia especially LDL > 117 mg/dl had higher sensitivity (80%) but specificity and accuracy was similar to total cholesterol   (³200mg/dl) and triglycerides (156mg/dl). Serum bhCG seems to be a more efficient marker in predicting PIH at second trimester. Conclusion: The present study indicates an increased risk of PIH in patients with elevated bhCG and dyslipidemia, especially elevated cholesterol and LDL in second trimester. As yet there is no practical, acceptable and reliable screening test for PIH, Serum bhCG seems to be a very good noninvasive early predictor for the development of PIH.

 Introduction: Hysterectomy is the most common surgical procedure among the women aged 30 to 47 worldwide. The aim of this study is to estimate the risk of early ovarian failure in premenopausal age group women undergoing hysterectomy with ovarian preservation. Methods: A prospective study was conducted among the women aged 30 to 47 years undergoing hysterectomy with or without bilateral oophorectomy (n=546) during 2010. Blood samples and questionnaire data were obtained annually for up to 5 years after hysterectomy.  Ovarian failure defined as follicle-stimulating hormone (FSH) levels 40 IU/L or higher, was calculated. Results: Ovarian failure occurred in among 106 women  from  total 543 women with hysterectomy without bilateral oophorectomy. Women undergoing hysterectomy were at nearly a twofold increased risk for ovarian failure as compared to women with intact uteri. Conclusions: Increased risk of earlier ovarian failure is a possible consequence of premenopausal hysterectomy. The cause of earlier ovarian failure is unresolved whether it is the surgery itself or the underlying condition leading to hysterectomy, physicians and patients should take into account this possible sequela when considering options for treatment of benign conditions of the uterus.

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