ABSTRACT
Background: Thrombocytopenia is second to anemia as the most common haematological abnormality during pregnancy. Objective of this study was to study the clinical profile, maternal and perinatal outcomes in thrombocytopenic antenatal patients.Methods: A prospective study was carried out in tertiary hospital, 280 pregnant women who attended the Antenatal clinic regularly were enrolled. All were screened for thrombocytopenia in third trimester (after 28 weeks), women with normal platelet (n=140) were taken in control group and those with low counts less than 150×109/L (n=140) were included in study group. Maternal and fetal outcome of thrombocytopenia in third trimester of pregnancy were studied.Results: Majority of women with gestational thrombocytopenia had mild thrombocytopenia (70.71%). 30.72% patients with thrombocytopenia had hemorrhagic manifestations. Maternal and perinatal complications like PPH (27.14%), puerperial sepsis (9.28%), placental abruption (5%), need for transfusion (20%), neonatal jaundice (20%), neonatal thrombocytopenia (12.14%), birth asphyxia (12.86%), NICU admission (12.14%), low Apgar (37.14%), need for resuscitation (30%), were more in patients with thrombocytopenia as compared to their age and parity matched controls.Conclusions: According to this study results, pregnancies with gestational thrombocytopenia, as compared to the control group, were at a higher risk of cesarean section, intrauterine fetal death, preterm delivery, low Apgar scores, more NICU admission rate, intracranial hemorrhage, neonatal death, or adverse maternal outcome.
ABSTRACT
Background: The study was undertaken to see the correlation between cervical cytology, histopathology and colposcopy in the diagnosis and management of various cervical lesions.Methods: It is a cross sectional study conducted at a tertiary care hospital in Mumbai, in the department of obstetrics and gynecology from February 2007 to March 2008. A total 55 sexually active women were enrolled for the study who belonged to age group greater than 20 years with history of chronic leucorrhoea or post-coital bleeding/spotting, intermenstrual bleeding/spotting or examination findings of erosion, an unhealthy cervix, a lesion bleeding on touch or an abnormal or suspicious Papanicolaou smear. These women then underwent cytology, colposcopy and cervical biopsy.Results: The accuracy of cytology when compared to colposcopy was 81.82%. The accuracy of colpo-histopathology was 83.6%. The combined accuracy was 76.36%.Conclusions: The simultaneous use of cytological studies and screening colposcopy has been shown to increase the cervical cancer detection. Colposcopy offers an excellent tool in the hands of a gynaecologist to evaluate the uterine cervix and it is not possible to develop this kind of perspective by any other method.
ABSTRACT
Background: Pregnancy and childbirth is normal physiological process with great pathological potential. The obstetricians are more concerned with the early recognition of fetal distress during labour and such an adverse outcome should be detected at the earliest point of time by an effective surveillance method. Cardiotocography as a part of biophysical profile has become an established diagnostic tool for fetal surveillance. To compare early perinatal outcome of normal and abnormal cardiotocography in terms of APGAR scores, need for neonatal resuscitation, NICU admission, perinatal death and mode of delivery.Methods: It was a cross-sectional study. 200 nulliparous/multiparous women with singleton pregnancy in cephalic presentation at gestational age 37-42 weeks in latent stage of labor were enrolled in the study and subjected to admission test in left lateral position using fetal monitor. Baseline FHR and contraction pattern were determined for 20 minutes and classification of patients was done into normal, and suspicious or abnormal according to the FIGO guidelines 2015.Results: Low APGAR scores, rate of LSCS, need for neonatal resuscitation, neonatal admission were more in the abnormal cardiotocography group. Cardiotocography in the current study has high sensitivity and high negative predictive value for detecting fetal distress.Conclusions: From the analysis of this study, it would be safe to conclude that an ominous cardiotocography should be managed appropriately without delay and obstetrician should be vigilant in suspicious as well as in normal admission test group for timely intervention for bettering the neonatal outcome.
ABSTRACT
Background: Abnormal uterine bleeding (AUB) is a common reason for women of all ages to consult their gynecologist and is one of the most common debilitating menstrual problems ending up in hysterectomy in developing countries. This study was done with the aim to observe the clinical and demographic profile of the patients and the pattern of AUB.Methods: It is an observational study, conducted in department of obstetrics and gynaecology, DR Rammanohar Lohia institute of medical sciences, Lucknow, Uttar Pradesh from August 2018 to July 2019. All patients in the reproductive age group with symptoms of abnormal uterine bleeding were included in the study.Results: Majority (37.50%) of the women were in the age group of 30-40 years. 71.66% were multiparous and maximum women (60%) were in normal BMI. 69.17% were belonging to middle class. Commonest presentation was menorrhagia (48.3%) followed by oligomenorrhoea (18.1%) followed by polymenorrhoea (17.27%).Conclusions: Excessive menstrual blood loss is a common reason for women to seek medical help and leads to large demands in health resources According to our study majority of the women with AUB were in the age group of 30-40 years, were multiparous with normal BMI belonging to middle class. Commonest presentation was menorrhagia. Following study highlights the clinical and epidemiological pattern of abnormal uterine bleeding of reproductive age group, which is crucial factor in management for these patients. In order to predict causal association, further more studies with larger sample size of higher level of evidence should be conduct to draw causal evidence.