Indian Journal of Obstetrics and Gynecology

Didelphys uterus or double uterus is one of the least common mullerian duct anomalies. It affects one to three in 3000 women worldwide. Uterus didelphys occurs due to Mullerian unification defects resulting in various abnormalities with the presence of 2 uteri, 2 cervices and often 2 vaginas. A high caesarean section rate of 51% has been reported in pregnancies with didelphys uterus. Reproductive outcome of women with this anomaly is better than that of women withunicornuate malformation due to better vascularity. Approximately 60% of women with uterus didelphys have successful full-term pregnancies. Renal anomaly scan be also associated with mullerian anomalies due to the common origin of mesonephric duct. The pregnancy outcome of women with uterus didelphys was comparatively good, but they still belong to a high-risk group. Women with uterine anomalies are more likely to experience adverse pregnancy outcomes.

Menopause is a part of natural aging process that causes a variety of physiological and psychological changes in the life of women. Various psycho social factors like lifestyle, health, culture, previous mood disorders all impact on menopause transition. Rapid changes in female reproductive hormones are implicated to cause fear, anxiety, depression and mood swings. However, insufficient coping abilities and poor adaptation to stress predisposes vulnerable women to emotional instability. Menopause is an unavoidable stage of life and acceptability of this fact depends on awareness, attitude, practices and health of women. Along with appropriate pharmacological treatment; lifestyle modifications and psycho-social support would go a long way to help women to steer through this phase of life with a sound mind.

Background: Managing obstetric emergencies in COVID-19 pandemic is a real challenge as these patients need timely intervention to save the life of mother and baby.

Aim: To study postpartum outcomes and complications in pregnant women undergoing emergency LSCS with COVID-19 positive status,an observational study.

Objective: Enlisting post-partum complications in COVID-19 positive women undergoing emergency LSCS. To study therequirement of drugs in postpartum period to deal with complications.

Settings and Designs: This was a observational study carried out in a tertiary health care center.

Material and methods: This study was carried out in a tertiary care health hospital which was designated as COVID-19 facility, from a period of June 2020 to January 2021. Total of 83 patients were taken into study. Patients undergoing emergency LSCS irrespective of gestational age were taken. Post-operative complications and drugs required in postpartum period were studied.

Results: In our study, CRP median value of 41.70 among the patients having complications was statistically significantly increased compared to CRPmedian value of 13.00 in patients having no complications (p-value 0.002). There were no significant differences in all other inflammatory markers.

Conclusion: There were no significant morbidities related to COVID-19 positive status in patients undergoing emergency LSCS, in our study

Objectives: In our study, we have tried to evaluate the causative factors for sterilization failure and also to discuss preventive measures to avoid maternal morbidities and unwanted pregnancies and as a result of sterilization failure especially in developing countries like India and tried to establish methods to decrease the rates of failed sterilization. Materials and Methods: This study is a retrospective study that was done on all the women presented with failed sterilization in the Department of obstetrics and gynaecology, GSL medical college and general hospital from May 2018 to May 2019. Results: During 1 year 20 cases of post-sterilization failure were reported, out of which 16 (80%) cases were intra-uterine pregnancies and 4 (20%) were ectopic pregnancies. Among which 17 (85%) cases underwent sterilization by modified Pomeroy’s method & 3(15%) underwent laparoscopic sterilization.14 (70%) cases presented to opd within 12 wks of gestation, out of which 2 cases (10%) underwent first trimester MTP.10 (50%)cases delivered at term by normal vaginal delivery, 1case delivered as preterm & 4 (20%) delivered at term by elective cesarean section. 7 cases underwent resterilisation by fimbriectomy & 13 cases underwent sterilization by bilateral salpingectomy. Conclusion: In the present study open method of sterilization was the most common cause of post sterilization failure than laparoscopic sterilization. Conversely, sterilization failure after one year is more likely due to natural tubal lumen regeneration through tubal recanalization or fistula formation. Hence proper counselling before sterilization should be done regarding the procedure, failure rates and morbidity. Surgical procedures should document Intra-operative adhesions, difficulty in identifying tubes, slipped rings or bands. Despite few failure rates tubal sterilization remains the most chosen method to control the population.

Aims and Objectives: The main objective of our study was to determine the sensitivity and specificity of International Ovarian Tumor Analysis (IOTA) Simple Ultrasound Rules and Risk of Malignancy Index (RMI) in differentiating benign from malignant ovarian masses and to compare the results generated with histological diagnosis.

Materials and Methods: A total of 50 consenting patients with ovarian mass coming to the Department of Obstetrics and Gynecology of our college in reproductive and menopausal age group were enrolled over a period of nine months. Data was collected using a standardized pretested proforma. Detailed examination of the subjects was done following which ultrasonographic assessment was done by gynecologists. In the subsequent visit or post admission blood investigations including CA-125 was done. Patient management as per departmental protocol was continued.

Results: The sensitivity, specificity, Positive Predictive value and Negative Predictive Value of RMI 2 in our study was 75.75%, 64.7%, 80.6% and 57.8% respectively. The sensitivity, specificity, Positive Predictive value and Negative Predictive Value of IOTA Simple Ultrasound rules in our study was 96.96%, 71.4%, 88.8% and 90.9% respectively.

Conclusion: In the present study we have seen that IOTA Simple USG Rules had better Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value than Risk of Malignancy Index (RMI 2). Though both the scoring systems have their own set of limitations IOTA Simple USG rules in our study seems to be a better scoring system; still we need to have a larger sample size, more Indian populationbased studies to extrapolate the same results to Indian populations.

Background: COVID 19 infection is the profanation for the mother in late gestation in respect to vascular complication due to sharing of the same Pathophysiology. Aim: To evaluate the incidence of vascular complications in covid positive mothers in late gestation. Objectives: a. To study the incidence of Preeclampsia, Fetal growth restriction, obstetric Doppler changes in covid positive mothers. b. To correlate the patho physiology of COVID 19 and vascular complication in pregnancy. c. To correlate the clinical and biochemical  ndings of Covid 19 infections with vascular complications in pregnancy. Settings and Design: This was the observational study carried out in a tertiary health care center. Materials and Method:A prospective observational study was conducted with 103 covid positive pregnant women who were presented to the department of obstetrics and gynaecology, Bharati Vidyapeeth deemed university, Pune between June 2020 to May 2021. Covid positive mothers with the onset of vasculopathies and other related complication have been observed. COVID 19 infection and pregnancy vascular pathology have been correlated. Conclusion: In our study, inflammatory markers has been observed significantly raised in covid positive women who were symptomatic with vasculopathies as compared to symptomatic covid positive women without vasculopathies. Clinical Significance:In present Covid era pregnant women are vulnerable to obstetric complications in late gestation as IUGR, Preterm labour with pre mature rupture of membranes, colour Doppler changes, Oligohydramnios, Preeclampsia .It is due to sharing the same patho physiology of Covid 19 and vasculopathies in late period of gestation.