RESUMO
Background: Abnormal uterine bleeding (AUB), is de?ned as a change in any or a combination of frequency, duration, or amount of bleeding, is a common gynecological complaint that affects 10?30% of reproductive?aged women and constitute about one?third of all outpatient gynecological visits. Mirena is a hormonal intrauterine device classified as a long-acting reversible contraceptive method. Women with heavy menstrual blood loss, the LNG?IUS can normalize blood flow. This high level of levonorgestrel in the endometrium induces dramatic effects leading to the unique mode of contraceptive and therapeutic action of the LNG?IUS. Initially developed to decrease the risk of expulsion of the intrauterine contraceptive device by reducing myometrial contractility.Methods: This study was a prospective interventional study conducted in the department of Obstetrics and Gynaecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, over a period of 6 months. MIRENA insertion was done in outpatient department. The effectiveness of device was assessed by reduction in amount of bleeding in case of abnormal uterine bleeding and in the form of subjective symptomatic improvement along with improvement in quality of life. Record of menstrual pattern. Pictorial Blood loss Assessment Chart was used to assess the amount of blood loss in each cycle. The women were called for follow-up after 1 month, then 3 months, and then 6 months and asked regarding the relief they have obtained from the antecedent menstrual complaints. Hemoglobin (Hb) estimation was done on the subsequent visits.Results: The mean subjective percentage reduction of blood loss reduced from 13.64% at the first visit to 72.16% at 6th month and the mean Hb level in our study before treatment was 6.8 which increased to 9.8 at the end of 6 month.Conclusions: The levonorgestrel-releasing intrauterine system-mirena, provides an incredible nonsurgical alternative in treatment of menorrhagia which is reversible and spares fertility.
RESUMO
Background: Pregnancy-related intrahepatic cholestasis is most prevalent hepatic disorder intense pruritus that affects the entire body including palm and sole. It is typically detected during second or third trimester. Pruritus frequently exacerbates at night, marked on the palms and soles of the feet and hands. Aim of this study was to evaluate bile acid and deranged liver function test in obstetrics cholestasis in pregnancy and to determine maternal fetal and outcomes.Methods: This prospective case series study was conducted in the Department of Obstetrics and Gynaecology, Muzaffarnagar Medical College. The present study was conducted in 50 women, who were selected from outpatient department of antenatal care from tertiary care, taken written permission before study. The medical records of all women with obstetrics cholestasis who delivered between December 2021and August 2022.Results: Subjects with IHCP has mean age of 30.11±5.03 year, found SGOT 40% in 100-200 and SGPT 44 % I (0-100) range and total bilirubin levels is 33 % in IHCP patients. In study found that LSCS due to 24% in fetal distress, 36% in MSL, 16% in IUGR, 14% preterm. Participants have 22% birth weight <2.5kg and 39 (78%) are under >2.5kg babies in IHCP patients and 24 % were underwent fetal distress and 24 % preterm delivery and 6 % got IUD . and no stillborn and 12% meconium.Conclusions: It causes maternal pruritus with impaired LFT and raised serum bile acids. Maternal morbidity is increased in terms of increased LSCS rates and discomfort due to pruritus.