Indian Journal of Obstetrics and Gynecology

Background: Induction of labour is initiation of uterine contractions before the onset in order to vaginally deliver the fetoplacental unit. Common reasons for induction of labour (IOL) are post-term and hypertensive disorders of pregnancy. Many women who undergo induction do not have a favourable cervix, so some methods of cervical ripening either pharmaceutical or mechanical are used. Aim & Objective: To compare the effectiveness of the transcervical Foley catheter and the prostaglandin E2 (PGE2) gel for the induction of labour. Methodology: The clinical trial was conducted for a period of two years OBGY department of Bharati Vidyapeeth University, Pune. 196 pregnant women which included and randomly via block randomization divided into two groups. Group A had 98 women in whom the transcervical Foley catheter was inserted and Group B included 98 women in whom the PGE2 gel was inserted vaginally for IOL. Bishop’s score and duration from induction to onset of labour was calculated. Data analysis was done and appropriate statistical tests were used. Results: In Group A (37.8%) as well as in Group B (41.8%) most of the pregnancies were primigravida. The most common indication for induction in both groups was postdatism. The adjuvant therapy was required in 66.3% and 54.1% of women in Group A & B respectively. Significant higher median values were observed in Bishop’s score at 12 hours as compared to 0 hour in both the groups. No significant association was observed between mode of induction and need of adjuvant therapy and induction to onset hours in both groups. Conclusion: The study shows that both Foley's catheter and PGE2 gel are equally effective in pre induction cervical ripening.

Context: Fetal Growth Restriction (FGR) is the single largest contributing factor to perinatal morbidity in nonanomalous foetuses. This research was conducted in the Department of Obstetrics and Gynaecology in a tertiary care teaching Hospital which included 100 singleton pregnant women with FGR. Aims: 1. To evaluate the maternal risk factors as possible contributors to FGR and related perinatal mortality. 2. To establish the decision-to-delivery time interval in growth restricted fetuses in correlation to gestational age and doppler examination. Methods and Material: Socio-demographic, maternal risk, Diagnosis- delivery interval in FGR and neonatal morbidities were studied. Serial deciding doppler were considered for evaluation of the perinatal outcome and mode of delivery. Statistical Analysis used: The association between doppler category and maternal risk factors was assessed by Chi-square test. The continuous variables were presented as mean ± standard deviation (SD) and the difference between the means was calculated by student’s ‘t’ test. Results: 76% women suffered concomitant comorbidities which could possibly contribute to the genesis of fetal growth restriction. 38% women had hypertensive disorders of pregnancy. Majority of women with FGR ~ 72% delivered by caesarean section. The doppler findings were abnormal among 60 subjects with preterm intervention and poor perinatal outcome. Conclusions: Obstetric Doppler has helped in early detection and timely intervention in babies with FGR with significant improvements in perinatal outcomes. Key Messages: The relevance of doppler in Obstetrics has shown utmost importance as a diagnostic tool in detection of fetal compromise and aiding for optimization for timing of intervention. This tool of Obstetric doppler has enhanced tremendous surveillance to growth restricted fetuses

Introduction: Pregnancy is an insulin resistant condition which allows physiologicaldyslipidemia to occur. This physiological dyslipidemia is essential for allowing fetal growth. However, when dyslipidemia crosses the physiological range, it predisposes the woman to preeclampsia development. Epigenetic reprogramming of the cells in the growing fetus increases the cardiovascular and metabolic complications in the adulthood. Material and methods: 330 antenatal patients were included in the study after matching inclusion and exclusion criteria. Lipid values were tested at 12-14 weeks of gestation and the women were followed up till delivery. Preeclampsia development was noted in women having deranged lipid values. Results: Of 330 antenatal patients enrolled in the study, 104 patients developed preeclampsia. All preeclampsia patients had hyperlipidemia in the 1st trimester. Conclusion: Early, cost-effective detection methods, management and timely delivery by outweighing risks of prematurity in baby and multiorgan failure,eclampsia and ultimately maternal mortality attributed to preeclampsia.

Background: Most ovarian cancers are detected in the late stages as there are nearly no clinical symptoms or signs at the early stage. Its high mortality rate has made it one of the most investigated fields in gynecological oncology. Aim: To study correlation between serum tumor markers and histopathology in diagnosed and operated cases of ovarian mass. Objectives: To study tumor marker levels in diagnosed and operated cases of ovarian mass and post operatively with the histopathology of said specimen. Settings and design: This is a prospective observational study carried out in a tertiary health care centre over 2 years from October 2019 to October 2021. Materials and Methods: The study population included 50 women diagnosed with an ovarian mass and operated for the same. After obtaining consent from the patient, detailed history was obtained, physical examination was done to examine the mass. Serum analysis for levels of tumor markers such as CA-125, b-HCG and Serum Lactate Dehydrogenase were assessed. Patient was investigated using ultrasound and if required MRI studies was also done. Post operatively, specimens were sent for histopathological studies. Conclusion: Among the tumor markers researched in this study, serum LDH can detect and predict the histological pattern of ovarian cancers as well as the malignant potential of the tumors. However, CA125 is able to predict only the malignant potential of the tumor. Beta hCG has no role in predicting the histology or malignant potential of tumors.

Millions of people around the world affect infertility in their reproductive age. Infertility has a major impact on the couples’ families and communities in which they live. Around 10% to 15% of couples are infertile in a general population. IVF is one of the option when we think to cure the infertility to those couple in which either of them has been diagnosed with problem of having a baby. In vitro fertilization IVF is one of the most promised types of assisted reproductive technology (ART). The latest report, from 2018, shows that 50% of women ages 35 gone through IVF procedures and resulted in a live birth of baby. 3.9% of the egg transfers done women ages 42 and older and it resulted in a live birth. If a woman is under childlessness, she was experiencing years of the stress from the beginning onwards from where the couple is incapable of having a baby. At that time, she gets to know that she needs to undergo in vitro fertilization, feeling of stress will magnify. IVF is a series of intense medical procedure so when a women passes through the treatment if she felt emotional stress is which is not unusual. Success rate of IVF treatment varies depending on several factors, so if unfortunately the treatment fails it will definitely cause a dramatic emotional distress in the couple especially in case of females. The objective of our study is to analysis the stress of women when she preparing for, during the procedure and after the treatment. In short it is concluded that before during and after the procedure of IVF women generally faces stress in its various degrees. In wide spectrum, marital, social, physical, emotional, financial, and religious status causes stress in women.

Clinical Efficacy of modified Pregnancy Unique Quantification of Emesis (PUQE score) in managemenet of emesis of pregnancy. Aims: To study PUQE score in ANC patients till 12 weeks, attending OPD or emergency department. To triage the patient as mild, moderate and severe case and to treat them accordingly. Settings and Design: Study was conducted in the Department of Obstetrics and Gynaecology in a tertiary care hospital. An Observational analytical study. The study included all the women with emesis in pregnancy from 1st September 2019 to 30th September 2021 matching the inclusion and exclusion criteria Study included all the women having emesis in pregnancy attending antenatal OPD and Emergency Medical Department, till 12 weeks.