ABSTRACT
Background: Polycystic ovarian syndrome (PCOS) is relatively common endocrine disorder in reproductive aged women, which leads to reproductive, metabolic and endocrine abnormality. About 70 to 80% patients with PCOS have complained of infertility due to anovulation. Due to advanced diagnostic facility by endoscopic evaluation in infertility, incidence of PCOS has increased now a days.Methods: This is study of 100 cases of infertility with polycystic ovarian syndrome and its pregnancy outcome. In this study, from May 2019 to April 2020, 100 cases of infertility with PCOS were studied at tertiary care hospital. Hormonal assay, ultrasound and laparoscopy were used as diagnostic technique. Clomiphene citrate, letrozole, metformin, and laparoscopic ovarian drilling were used as treatment modalities.Results: The maximum number of patients in the study group are seen in the age group of 21-25 years. Menstrual irregularities are the most common presenting symptom affecting 70% females. Primary infertility is most commonly associated with PCOS. In PCOS, there is increased LH:FSH ratio. On USG examination, there are enlarged ovaries in 82% cases.Conclusions: PCOS is an emerging disease of new generation with high prevalence in infertile women. After proper diagnosis, management with lifestyle modification, pharmacotherapy with clomiphene citrate, letrozole and metformin are used as per necessities. Operative laparoscopy with ovarian drilling is the main treatment which results in good conception rate.
ABSTRACT
Background: Placenta previa is defined as placenta implanted partially or completely in the lower uterine segment. It contributes upto 30% of the cases the antepartum hemorrhage. This catastrophic complication not only poses a risk to the fetus but also endangers the mother’s life. The objective of the study was to determine the incidence and risk factors, obstetric management, maternal mortality and morbidity and perinatal outcome in women presenting with placenta previa.Methods: It is the prospective study of 50 cases carried out to study the maternal and perinatal outcome in cases of placenta previa in tertiary care hospital. This study included antenatal patient diagnosed as placenta previa by ultrasound >28 weeks to full term pregnancy. This data was compiled and analyzed for maternal and neonatal outcome.Results: In the present study, the incidence of placenta previa is 0.8% among which 42% of cases having age group of 25-29 years and 72% cases are multigravida. In this study 60% cases have major degree of placenta previa and 66% cases have previous history of caesarean section. Out of total cases 96% cases delivered by caesarean section and 4% had Normal delivery. NICU admission in the study is 28 babies i.e. 56%. There is no maternal mortality seen in the present study.Conclusions: Risk factors that increase the cases of placenta previa are multiparity, previous caesarean section, previous abortion. Placenta previa is major risk factor for adverse maternal and perinatal outcome. Good antenatal care, availability of emergency obstetrics services with senior obstetricians, blood bank facility, ICU care and NICU services can improve maternal and neonatal outcome in high risk cases.
ABSTRACT
Background: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy. Prophylactic oral iron is recommended during pregnancy to meet the increased requirement of iron. In India, more than 50% women become pregnant with low baseline haemoglobin level resulting in high incidence of moderate to severe anaemia in pregnancy where oral iron therapy cannot meet the requirement. This study was undertaken for critical evaluation of iron sucrose in terms of efficacy, safety, and feasibility along with any reduction in blood transfusion rate. Aims & Objective: To evaluate the efficacy of intravenous Iron sucrose in antenatal patients with Iron deficiency anaemia and to study the side effects of intra venous Iron sucrose. Material and Methods: This prospective study was conducted from Nov 2012 to June 2013 at VS General Hospital, Ahmedabad. 60 antenatal patients found to have anaemia having Hb level < 9 gm% were admitted and given intravenous iron sucrose therapy 100mg alternate day after calculating the dose of the iron requirement. Results: In patients having moderate anaemia (Hb 7-9 gm%), the rise in Hb found to be 2.17 ± 0.45 gm% from pre-treatment Hb of 7.88 ± 0.58 gm% to 9.9 ± 0.53 gm%. In patients with severe anaemia (Hb < 7 gm%), the rise in Hb was observed up to 2.73 ± 0.51 (SD) gm% after 1 month of iron sucrose treatment. No major side effects or anaphylactic reactions were noted during the study period. Conclusion: Parenterally administered iron sucrose elevates Hb and restores iron stores earlier and also that intravenous iron administration has led to the reduction in the rate of blood transfusion rate.
ABSTRACT
Background: With all the modern needs of contraception rising on one side, infertility is still a major challenge to the gynaecological practitioners on other hand. Polycystic ovarian syndrome (PCOS) is the most common cause of anovulatory infertility, being found in ∼75% of cases. PCOS now proves to be a significant factor in female infertility with prevalence of 0.6 to 3.4% in infertile couples. With improving laboratory facilities, sonography and with routine laparoscopic evaluation of infertility, PCOS has shown a remarkable increase of incidence in recent years. Aims & Objective: The diagnosis of PCOS by ultrasonography & investigations like LH, FSH, Prolactin and or Laparoscopy. The evaluation of treatment options like clomiphene citrate, metformin and laparoscopic ovarian drilling. Material and Methods: This is a study of 100 cases of infertility with polycystic ovarian syndrome and its pregnancy outcome. In this study from May 2011 to April 2013,100 cases of Infertility with PCOS were studied at the tertiary care center. Hormonal assay, Ultrasound and laparoscopy were used for diagnosis. Clomiphene citrate, metformin and laparoscopic ovarian drilling were used as treatment modalities. Results: In our study 58% patients were in the age group of 21-25 years and 100% patients complained of infertility among which 60% were of primary type. LH:FSH ratio was more than 1.6 in nearly 82% patients. Among all treatment modalities conception rate with Clomiphene citrate was 40%, with metformin it was 20% and with laparoscopic ovarian drilling followed by C/C it was 65%. Conclusion: PCOS is emerging disease of the new generation found more in young adults being the leading cause of infertility. Apart from diet and exercise changes in lifestyle modification treatment is required in most patients with good conception rate with C/C and laparoscopic ovarian drilling.