Indian Journal of Obstetrics and Gynecology

Background: Women with a prior stillbirth are at elevated risk for adverse outcomes in subsequent pregnancies. Identifying these outcomes and contributing factors is essential for improved antenatal surveillance and care. Objective: To assess pregnancy outcomes in women with a prior history of stillbirth and to classify the etiology of previous stillbirths using the ReCoDe system (Relevant Condition at Death). Materials and methods: This was a prospective observational study conducted at a tertiary care center in Pune, India, from June 2023 to June 2025. A total of 116 pregnant women with a prior history of stillbirth were enrolled after informing consent the subjects were enrolled in a study. Detailed demographic, obstetric, and clinical data were collected. Pregnancy outcomes were analyzed and the causes of previous stillbirth were categorized using the ReCoDe classification system. Results: In this study, the mean maternal age was 29.2 years. Most participants (67.2%) had a BMI in the overweight or obese range. Hypertensive disorders were significantly associated with placental abruption (p=0.01) and uteroplacental insufficiency (p=0.004). Gestational diabetes mellitus was present in 13.8% of cases. Fetal growth restriction (FGR) was significantly associated with preterm birth (p=0.01) and NICU admission (p=0.01). The recurrent stillbirth rate was 10.3%. The ReCoDe classification identified hypertensive disorders (26.7%) and placental abruption (18.1%) as the most common causes of prior stillbirths, while 31.9% remained unclassified. Conclusion: Women with prior stillbirths exhibit significantly higher rates of adverse maternal and fetal outcomes in subsequent pregnancies. Hypertensive disorders and FGR are major contributors. Structured antenatal monitoring and use of classification systems like ReCoDe can guide risk stratification and clinical management.

Background: Abnormal menstrual patterns are many times associated with thyroid dysfunction which is yet an under evaluated cause. Objective: This study aims to determine the association between abnormal uterine bleeding (AUB) and thyroid dysfunction. Materials and methods: This prospective, single-center, cross sectional analytical study was conducted with all women who were attended with AUB at investigation site. In total, 256 women were enrolled in study. Those with diagnosed thyroid dysfunction were excluded from the study. After assessment of the menstrual pattern, all women were subjected for Abdomino-pelvic ultrasonography and blood tests hemogram and thyroid profile. The women were divided into these categories based on thyroid values: Euthyroid, hyperthyroid, subclinical hypothyroidism and hypothyroid. Results: In this study, the average age of women was 41.48 years. Out of a total of 256 individuals, the majority (62.1%) were found to be euthyroid, indicating normal thyroid function. Hypothyroidism was observed in 29.3% of the women, while hyperthyroidism accounted for 6.3%. A smaller proportion (2.3%) exhibited subclinical hypothyroidism. The most frequent complaint was heavy menstrual bleeding (HMB), reported by 160 individuals, predominantly among those with euthyroidism (61.3%) and hypothyroidism (33.1%). Metrorrhagia occurred in only three cases, two of which were in individuals with hypothyroidism (66.7%). Isolated thyroid dysfunction was present in 15.6% of the study population, which is significant. Conclusions: Hypothyroidism was significantly associated to HMB. Most women were euthyroid, but altered thyroid function, especially hypothyroidism, influenced menstrual irregularities in a substantial subset. There is need to shed light on isolated thyroid dysfunction.

With increase in the longevity of life, the population of women in midlife and older is increasing. Midlife marks a challenging period of a women’s life where hormonal changes and menopausal transition occur and the incidence of non communicable diseases increases. This period of life experience depends on various factors such as ethnicity, country of residence, literacy and socioeconomic class. Gender itself is a key factor that determines an individual’s health. The need for a healthy lifestyle from early on needs to be emphasized as it plays a key role in healthy aging. There is also a need to spread awareness on prevention of NCDs and good post-retirement support. National health programs must include older adults and specialized and personalized care given according to their needs. This will help prevent health deterioration in midlife that reduces functional ability, work productivity and increased healthcare costs, leading to economic loss.

Breastfeeding is globally recognized as a cornerstone of infant and maternal health, offering myriad benefits from reduced infant mortality and morbidity to improved maternal postpartum recovery. However, suboptimal breastfeeding practices remain a significant public health challenge worldwide. Primigravida mothers, experiencing pregnancy and impending motherhood for the first time, represent a particularly vulnerable group whose knowledge and attitudes towards breastfeeding can profoundly influence their initiation and continuation rates. This analytical study aimed to assess the level of knowledge regarding breastfeeding among primigravida mothers attending antenatal clinics and to identify potential gaps and associated factors. A descriptive cross-sectional design was employed, involving a hypothetical sample of 350 primigravida mothers recruited through convenience sampling from selected antenatal clinics in a metropolitan area. A structured questionnaire, encompassing socio-demographic data and 25 knowledge-based questions on benefits, techniques, duration, common problems, and storage, was used for data collection. Data analysis included descriptive statistics (frequencies, percentages, means) and inferential statistics (Chi-square test) to explore associations. Hypothetical results indicate that while primigravidae possessed a moderate overall knowledge level, significant deficiencies were noted regarding specific aspects such as proper latching techniques, management of common breastfeeding problems, and breast milk storage guidelines. Education level and exposure to antenatal breastfeeding education were found to be significantly associated with higher knowledge scores (p<0.05). These findings underscore the critical need for targeted and comprehensive antenatal breastfeeding education programs tailored to the specific knowledge gaps identified among primigravida mothers. Such interventions can empower first-time mothers with the confidence and skills necessary to initiate and sustain optimal breastfeeding practices, ultimately contributing to improved maternal and child health outcomes.