Genito-urinary fistulae--an evaluation.

A total number of 39 cases of genito-urinary fistulae were managed during the period January, 2001 to August, 2006 in the department of obstetrics and gynaecology, Burdwan Medical College, Burdwan. All patients were evaluated clinically and investigations done accordingly. The incidence of genito-urinary fistula was 0.74% of all gynaecological operations. Out of 39 cases, 23 were primipara, 41.02% were in the age group 20-30 years. In 20 cases the site was at midvaginal region. Prolonged and obstructed labour constituted the major aetiology in 25 cases. Surgery was contemplated in 34 cases. Thirty cases had successful operation after primary surgery, 3 cases had successful repair after second attempt. Only one case needed third attempt. Urethral catheter was required in 15 cases. Proper training of the care providers, more vigilant intrapartum care and timely referral are the important factors to minimise the distressing disorder.

Iodine deficiency disorders among the pregnant women in a rural hospital of West Bengal.

BACKGROUND & OBJECTIVES: Iodine deficiency disorder (IDD) is a major nutritional problem in India. The pregnant women and their neonates have been important target groups for study of the prevalence of IDD in a community. No such study was available to assess the prevalence of IDD among the pregnant women and neonates in the state of West Bengal. The present study was undertaken to assess the status of IDD in the pregnant women and its effect on the neonatal thyroid function in Burdwan district of West Bengal. METHODS: The present study was a hospital-based, cross-sectional, non-interventional study among 267 full term pregnant mothers, and the neonates born to them. One hundred non pregnant healthy women were selected as controls. The overall iodine status of the pregnant and non pregnant women was estimated by measuring the urinary iodine excretion (UIE) and the serum thyroid stimulating hormone (TSH) levels. The neonatal thyroid function was estimated by measuring the TSH levels in their cord blood. RESULTS: A total of 78.4 per cent pregnant women showed UIE > 10 mug/dl with 7 per cent having a UIE < 5 mug/dl. The median UIE and the serum TSH values in the pregnant women were found to be 14.4 mug/dl and 4.1 mIU/l, respectively. No statistically significant difference was found when compared with the control values. Only 2.9 per cent of the neonates showed a cord blood TSH value > 5 mIU/l which is just below the recommended criteria for mild endemicity for IDD in the study population. INTERPRETATION & CONCLUSION: Pregnant women of the study area were iodine repleted. The neonatal thyroid function was also within normal range. The findings of the present study indicates that the iodine supplementation of the salt should be maintained in the area with periodical surveillance.