ABSTRACT
Background: Pregnancy creates an important opportunity to screen the cervix for neoplastic and infectious diseases and to spread awareness. A pap smear is simple, cost effective and safe in pregnancy. In low resource countries, this may be the only opportunity when the woman visits a health centre. It also helps identify and treat infections that could hamper the pregnancy outcome. Objective of the study is to determine the awareness of pap smear as a cervical cancer screening test in antenatal women; to determine the incidence of cervical neoplasia and premalignant lesions of the cervix in antenatal women.Methods: A cross-sectional study was carried out between November 2018 to April 2019. Inclusion criteria were pregnant women in the first trimester. Exclusion criteria were pregnancy greater than 12 weeks, symptoms of vaginal infection, history of sexual intercourse or vaginal medication or bleeding in the last 48 hours or a normal pap smear in the last 3 years. The reporting was done as per Bethesda 2014.Results: 308 women underwent a pap smear in their 1st trimester. 94% were satisfactory smears and 3(0.9%) an abnormal smear (2 LSIL and 1 ASCUS). 31.2% had inflammatory smears. Only 15 women were aware of pap smear as a test for cancer cervix screening and all these women were graduates and above. No women had ever had a pap smear test in the past. One fifth of women studied had 1 or more risk factor the commonest being early age at first intercourse.Conclusions: The antenatal period should be utilized as an opportunity to screen women for cancer cervix.
ABSTRACT
Background: The safety and efficacy of the Post-Partum Intra Uterine Contraceptive Device (PPIUCD) has been documented worldwide. With increasing institutional deliveries and greater sensitization, the aim is to increase PPIUCD insertions. Many areas still report poor acceptance. Objectives of this study to determine the proportion of antenatal women willing to accept PPIUCD insertion and the reasons behind refusal to accept this method.Methods: A prospective questionnaire study was done between January 2019 to June 2019 of 200 women. Inclusion criteria were antenatal women in the 2nd/3rd trimester. Exclusion criteria were those opting for a permanent method of contraception and those with a contra-indication.Results: Eighty-four women (42%) had never used any method of contraception. Earlier Intrauterine device (IUD) use (including both interval and PPIUCD) was in only 18.9% of all contraceptive users. Only 2 women in the group had ever used PPIUCD. 79% of women were aware of IUDs. Those unaware were mainly nulliparous. Amongst those aware of an IUD, 88 (56%) were aware it could be inserted postpartum. Only 18% were aware it could be inserted intra-cesarean. All women who participated were offered the option for a PPIUCD. Fifty-nine (29.5%) of all women expressed their willingness but on follow up till delivery only 18 of these women got a PPIUCD inserted. Amongst those not willing for the PPIUCD insertion the commonest reason was general apprehension (39%) followed by partner refusal (33%) and fear of complications (31%). Six women (4.2%) gave history of complications following earlier use and were unwilling for its repeat use. Conclusion: The large unmet need for contraception in India can be solved through repeated counselling and discussions with the woman during her antenatal visits. Alleviating apprehension and addressing concerns of the couple will increase PPIUCD acceptance.
ABSTRACT
ABSTRACT Background: Preeclampsia is one of the major health problems causing maternal morbidity and mortality, complicating 3-8% of pregnancies. It has been suggested that the alterations in the coagulation and fibrinolysis play a role in the pathogenesis of preeclampsia. The markers of platelet activation include platelet count, platelet distribution width, mean platelet volume and plateletcrit. Study design: It was a case-controlled study which included a total of 60 patients (30 cases and 30 controls). Blood samples were collected and the platelet indices - platelet count, plateletcrit, mean platelet volume and platelet distribution width - were evaluated using the Sysmex XN1000 and compared between the two groups. Results: The MPV and PDW also showed a significant difference (p > 0.05) between the two groups, with a significant positive correlation with increasing blood pressure (MPV - r = +0.6126, p < 0.05 and PDW - r = +0.6441, p < 0.05). The PC and PCT had lower values in the preeclampsia patients, however the difference between the two groups was not statistically significant. Conclusion: The MPV and PDW showed a significant difference between the two groups and increasing values with increasing BP. However, the PC and PCT in our study did not show a significant correlation with preeclampsia. Thus, the platelet indices, mainly the MPV and PDW, which are economical and easily available, can be reliable in the prediction and early diagnosis of preeclampsia, as well as a marker for the severity of preeclampsia.