Obstetrical outcome of pregnancy complicated with first trimester bleeding and subchorionic hematoma

Background: First trimester bleeding complicates around 20-27% of pregnancy. Objective of this study was to evaluate and compare the feto-maternal and pregnancy outcome in patients presenting with live pregnancy complicated with first trimester bleeding and subchorionic hematoma with those without subchorionic hematoma.Methods: In this prospective observational study, based on ultrasonography, live pregnancies were categorized into two groups, first group having first trimester bleeding with subchorionic hematoma and second with first trimester bleeding only without any hematoma. They were evaluated for the end outcome of pregnancy in terms of abortion and continuation. Continued pregnancies were evaluated for antenatal complications, delivery and intrapartum events along with fetal outcomes.Results: Outcome of pregnancies presenting with first trimester bleeding in terms of abortion was similar in both the groups, 22.8% and 21.5% with hematoma and without hematoma respectively. Incidence of preeclampsia was 11.4% and Fetal growth restriction was 7% in pregnancies with first trimester bleeding with hematoma and was significantly higher than those without hematoma which was 3.07% for preeclampsia and 3% for fetal growth restriction. Incidence of antepartum haemorrhage was higher in hematoma group but the result was not statistically significant. 20% pregnancies with first trimester bleeding with hematoma had preterm deliveries, while it was 7.7% in pregnancies without hematoma and the difference was statistically significant. Low birth weight had occurred in 20% of babies in first group of patients while 4.6% in second group, difference being statistically significant.Conclusions: We found that live pregnancies with first trimester bleeding and subchorionic hematoma were associated with similar risk of miscarriage and antepartum haemorrhage while increased risk of preeclampsia, fetal growth restrictions, preterm birth, non-reassuring fetal heart pattern, caesarean delivery and low birth weight baby when compared to patients with first trimester bleeding without subchorionic hematoma. There was no difference in 5 minutes Apgar score and the NICU admission in both the groups.

Hypervascular retained products of conception: dilemma of diagnosis and management

Retained products of conception (RPOC) are a partial retention of placental tissue after dilation and curettage (D&C) procedures or vaginal deliveries. Ultrasound scan reports sometimes mention the presence of increased endometrial / sub‐endometrial vascularity in the context of retained products of conception. This raises the possibility of serious intra‐operative haemorrhage because of the possibility of arterio‐venous malformation. The aim of this article is to discuss the diagnosis and management options of retained products of conception (RPOC) with increased vascularity where simple dilatation and curettage may lead to life threatening haemorrhage and endanger the life of the patient and to enlighten the importance of evaluation of vascularity in all cases of RPOC prior to dilatation and curettage in order to avoid the dreaded complication of massive haemorrhage.

An Ayurvedic And Contemporary Overview Of Menopause: A Conceptual Approach

Menopause is generally defined as the cessation of menses for period of 12 months or a period equivalent to three previous cycles or the time of cessation of ovarian function resulting in permanent amenorrhea. During the period of menopause the women enters an estrogen deficient phase which leads to the various symptoms. This period is generally associated with manifestation of aging process in women. Other symptoms include hot flushes, sweating, mood changes, loss of libido etc. These symptoms affect the quality of life of the female. Hormone Replacement Therapy (HRT) is the only alternative available for menopausal syndrome in modern medicine. It also has a wide range of side effects on the body of the female. In Ayurveda the context of menopause is depicted as “Jarapakwa avastha†of body and Rajonivrutti. Rajonivrutti janya laksana is a group of symptoms produced by degenerative changes in the body. Degenerative changes are explained in Ayurveda as Dhatukshaya lakshana. Vata dosha dominance is seen in the later stage of life. To combat the degenerative process of the body tissue, Acharyas have described Rasayana Chikitsa. Rasayana includes drugs which promotes longevity and improve the quality of life. Thus an effort is being made here, to study the effect of Rasayana therapy, on Menopausal syndrome, conceptually, based on Available information in Ayurvedic texts and other contemporary resources. The basic Rationale for this study is to establish a reliable platform for further Research on the Said subject.

A retrospective study of fungal corneal ulcer from the western part of Uttar Pradesh.

Background: Infectious keratitis is a major cause of avoidable blindness worldwide. Fungus is an important aetiological agent of infectious keratitis following corneal trauma with vegetative matter. This infection should be promptly treated to limit the morbidity and dangerous sequelae. The purpose of this study was to detect causative agents from corneal scrapings and to identify the predisposing factors of mycotic keratitis. Methods: Corneal scrapings were taken in full aseptic precautions in total 112 suspected patients for fungal etiology and were subjected to direct examination by 10% KOH mount, gram stain and culture. Results: A total 112 cases of suspected corneal ulcers were subjected to KOH mount to detect fungal elements in corneal scraping and culture to isolate aetiological agents. In our study 29 (25.8%) samples were found positive in KOH mount and fungus was isolated from the all KOH positive samples. Males were more commonly affected and were mostly in the age group of 30-50 years. Fusarium species was the most common fungus isolated followed by Aspergillus species. Conclusion: Mycotic keratitis is a serious problem usually following corneal trauma, it requires rapid detection and identification of fugal agents for treatment to prevent disastrous consequences.