ABSTRACT
Background: The incidence of maternal cardiac diseases has an adverse effect on pregnancy outcomes. The present study was done the objective to determine the Incidence and distribution of cardiac disease in pregnant patients, to assess mode of delivery and fetomaternal outcome in pregnancy with heart disease patients.Methods: This was a hospital based prospective observational study that include 65 pregnant women with diagnosed cardiac disease or had symptoms and signs suggestive of cardiac disease during the period from January 2018 to December 2019. Baseline data recorded including age, parity, gestational age, cardiac lesions, New York heart association (NYHA) functional class, use of cardiac medications, thorough clinical examination including chest and cardiovascular auscultation, ECG and echocardiographic assessment of left and right ventricular systolic function. Fetomaternal outcome was analysed in the study.Results: The mean age of the patients was 24.33±2.93 years (ranging from 19-36 years). 34 patients (52.30%) were primigravida. Majority (58.46%) cases were from rural area. Majority patients (70.77%) are present between 37-40 weeks of gestational age. Most of patients had vaginal delivery (64.62%). 43 patients (66.15%) diagnosed with heart disease after pregnancy, while 22 patients (33.85%) are diagnosed before pregnancy for heart disease. Neonatal complications were seen in in 35.38% of patients. Cardiac complications were present in 40% of patients. majority of fetal complications are in nonoperated patients (46.15%).Conclusion: The management of pregnant women with cardiac diseases requires multidisciplinary approach to prevent morbidity and mortality. It is necessary to optimize healthcare facilities to obtain maximum maternal and fetal outcome.
ABSTRACT
Background: Infertility is a global reproductive health issue that affects many individuals and family. The aim of the present study was to evaluate the laparoscopic finding in infertility cases.Methods: Present study is a prospective study on laparoscopic evaluation of female infertility at Panna Dhai Mahila Chikitsalaya, Udaipur, Rajasthan, India. This study was done for the duration of one year from January 2017 to December 2017. Present study included total 100 cases randomly selected attending OBG OPD with both primary and secondary infertility.Results: Out of 100 cases infertile women 62 cases (62%) were of primary infertility and 38 cases (38%) were of secondary infertility. The mean duration of infertility was 3.7 years. Laparoscopic finding were as follow 42% had polycystic ovaries, 33% women had tubal pathology diagnosed on laparoscopy in which 22 women had tubal blocks diagnosed on chromopertubation and among them 19 had cornual block and 3 had ampullary block ,11% uterine finding and 7 women had adhesions in the pouch of douglas and one women had obliterated. About 20 women (20%) conceived during the period of study. Seven women had post laparoscopic complication two women complained of shoulder pain and another four of abdominal pain post operatively.Conclusions: Laparoscopy is the gold standard for diagnosing tubal factors, peritoneal factors, endometriosis and adhesions, because no other imaging technique provides the same degree of sensitivity and specificity and it should be considered in infertility workup for early treatment decision.