ABSTRACT
Background: The prevalence of infertility ranges from 3.5% to 16.7% in more developed nations and from 6.9% to 9.3% in less developed nations, with an estimated overall median prevalence of 9%. The present study was aimed to evaluate the role of hysterolaparoscopy in the study of primary and secondary infertility, to identify the various pathological conditions in female reproductive tract leading to primary/ secondary infertility, to develop a plan for therapy and management at the same time.Methods: This is a one-year prospective study conducted in obstetrics and gynecology department at D. Y. Patil hospital, Navi Mumbai, Maharashtra, India. All infertility patients seen in outpatient department, who were medically fit, willing for surgery and willing to get enrolled for study were included in this study.Results: Out of total 120 cases for infertility evaluated, tubal factor is the most common cause (28.3%) in both primary (23.3%) and secondary (43.3%) infertility group as seen on laparoscopy. Followed by ovarian factors (28.3%), peritoneal (11.6%) and uterine factors (10.8%). In 27 cases (22%), there were no detectable pathology at laparoscopy. In this study, hysteroscopy findings show 5.8% cases to have submucous fibroid uterus, 3.3% submucous polyp, 1.6% subseptate uterus, 0.8% septate uterus, 0.8% intrauterine adhesions, 0.8% bicornuate uterus and cervical stenosis 1.6% of patients.Conclusions: From this study, it is concluded that the diagnostic hysteroscopy and laparoscopy is an effective and safe tool in evaluation of female infertility. It provides direct and magnified view of all pelvic organs.
ABSTRACT
Background: Cesarean section is becoming a more common delivery type worldwide. The objective of this study was to compare surgical morbidity in extraperitoneal versus transperitoneal techniques of cesarean section.Methods: A total of 60 patients was included in this study out of which 30 underwent extraperitoneal cesarean section(ECS) and 30 patients underwent transperitoneal cesarean section (TCS) and compared both the techniques with respect to nausea or vomiting intra-operatively, pain score (as measured by visual analogue scale) post operatively, return of bowel function and blood loss.Results: Intra-operative nausea and vomiting was noted in 33.34% of patients in TCS group while none of the patients in ECS group had any such complaints. No difference was noted in average blood loss between the 2 groups. Post-operative pain in ECS was 4.13 as compared to 6.86 in TCS. Return of bowel sounds in ECS group was much earlier (5.46 hours) as compared to TCS group (11.33 hours).Conclusions: We conclude that extraperitoneal technique is advantageous over transperitoneal approach. Decreased nausea and vomiting, early return of bowel function in the post-operative period, decreased post-operative pain allowing early feeding and mobilization are definite benefits of this technique. This further helps in making a relatively smoother post-operative recovery.
ABSTRACT
Reversible visual disturbances in patients with eclampsia may be due to either retinal detachment or retinal arteriolar vasospasm or thrombosis of the central retinal arteries or PRES (posterior reversible encephalopathy syndrome). Although retinal arteriolar vasospasm is the most common mechanism of visual disturbance, cortical blindness may occur in 1% to 15% of patients with eclampsia. Reporting herewith a case of reversible cortical blindness in the setting of severe preeclampsia complicated with eclampsia.
ABSTRACT
Background: There has been a rising incidence of preterm labour in India. Preterm labour poses greater risks of morbidity and mortality of the preterm neonates. Various factors contribute towards risk of preterm labour and its outcome. Addressing these factors appropriately improves the outcome in pregnant women.Methods: This prospective observational study was conducted in department of obstetrics and gynaecology from the period of July 2017 to July 2018.Results: The present study was in 98 patients admitted in our hospital with preterm labour. Clinical profile of those patients was studied. Statistically significant association was found between administration of antibiotics and tocolysis in prolongation of pregnancy (p value=0.00). There was an association found between gestational age at birth and immediate neonatal outcome (p value=0.00). Preterm labour was more common in multigravidae (62.4%) and women with cervical length less than 3 cm (85.17%).Conclusions: Preterm labour can be expected more commonly in multigravidae, pregnant women with cervical length less than 3 cm and in presence of high-risk factors. Anticipation of preterm labour, judicious use of antibiotics, tocolytics can improve the outcome of preterm labour.