RÉSUMÉ
Background: Recurrent pregnancy loss occurs in approximately 1-2% of reproductive aged women. Aetiology is unknown in approximately 50% of RPL. Common established causes include uterine anomalies, antiphospholipid syndrome, hormonal and metabolic disorders, and cytogenetic abnormalities. Maternal age and number of previous miscarriages are two independent risk factors. The study was conducted to determine the pregnancy outcomes in women with history of recurrent pregnancy loss.Methods: A hospital based cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal. The study was carried out during a period of 2 years with effect from September 2019 to August 2021.Results: A total of 116 pregnant women with history of recurrent pregnancy loss were included in the study. The mean age among participants was 30.28±5.48 years. The average number of abortions prior to this pregnancy was 2.53±1.02. About 85.34% had spontaneous onset of labour and nearly equal proportion of (48.27% and 46.56%) of the participants delivered by NVD and CS. Maternal complications were present in 51.72%. Most common were hypertensive disorder (12.06%) and preterm labour (12.06%). Fetal complications were observed in 22.4% of newborn, commonest being low birth weight.Conclusions: Women with history of recurrent pregnancy loss encountered increased adverse maternal complications however fetal complications were similar to that of the general population. The definition, diagnosis and treatment of patients with a history of RPL remains difficult. Increased antenatal surveillance to reduce the risk of pregnancy complications with better screening of the obstetrical history and the necessary investigations to identify a treatable cause associated with previous miscarriages can lead to early prophylactic interventions for a better outcome.
RÉSUMÉ
Background: Recurrent pregnancy loss occurs in approximately 1-2% of reproductive aged women. Aetiology is unknown in approximately 50% of RPL. Common established causes include uterine anomalies, antiphospholipid syndrome, hormonal and metabolic disorders, and cytogenetic abnormalities. Maternal age and number of previous miscarriages are two independent risk factors. The study was conducted to determine the pregnancy outcomes in women with history of recurrent pregnancy loss.Methods: A hospital based cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal. The study was carried out during a period of 2 years with effect from September 2019 to August 2021.Results: A total of 116 pregnant women with history of recurrent pregnancy loss were included in the study. The mean age among participants was 30.28±5.48 years. The average number of abortions prior to this pregnancy was 2.53±1.02. About 85.34% had spontaneous onset of labour and nearly equal proportion of (48.27% and 46.56%) of the participants delivered by NVD and CS. Maternal complications were present in 51.72%. Most common were hypertensive disorder (12.06%) and preterm labour (12.06%). Fetal complications were observed in 22.4% of newborn, commonest being low birth weight.Conclusions: Women with history of recurrent pregnancy loss encountered increased adverse maternal complications however fetal complications were similar to that of the general population. The definition, diagnosis and treatment of patients with a history of RPL remains difficult. Increased antenatal surveillance to reduce the risk of pregnancy complications with better screening of the obstetrical history and the necessary investigations to identify a treatable cause associated with previous miscarriages can lead to early prophylactic interventions for a better outcome.
RÉSUMÉ
Background: Postmenopausal bleeding (PMB) is one of the most common reasons for referral to tertiary care centres with a strong suspicion of malignancy. Endometrial cancer is the most common cause of gynaecological malignancy in the West, but in India the incidence rates are low. Eighty to ninety percent (80-90%) women have benign conditions in India. The aim and objectives of my study are to evaluate causes of PMB and sociodemographic characteristics among postmenopausal women.Methods: A hospital based analytical cross-sectional study was conducted among women above 45 years with PMB admitted in the department of obstetrics and gynaecology, regional institute of medical sciences (RIMS), Imphal. The study was conducted for a period of two years from October 2019 to September 2021.Results: In this study, out of 50 postmenopausal women 35 (70%) belong to age group >50 years and only 15 (30%) belong to age group <50 years. The most common cause of PMB in this study was found to be endometrial atrophy (12 out of 50) and two thirds of them having ET between 2-4 mm. This association is found to be statistically significant. The incidence of genital tract malignancy in our study is 14%. Incidence of endometrial carcinoma (8%) is slightly higher than cervical cancer (6%). The incidence of premalignant lesions (endometrial hyperplasia with atypia, endometrial intraepithelial neoplasia, cervical intraepithelial neoplasia) is 20% in this study. The study did not show significant association of clinical variables with benign, premalignant or malignant causes of PMB.Conclusions: With increase in life expectancy the incidence of PMB is expected to increase in future. Since the incidence of malignancy is quite high, any bleeding in that age group should be evaluated in the line of malignancy unless proved to be otherwise.