RESUMO
Background: Menopause is defined according to WHO as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. It is defined as uterine bleeding occurring after at least 1 year of amenorrhoea. Considering the high accuracy of hysteroscopy in evaluation of postmenopausal bleeding, the present study was carried out with an aim to evaluate hysteroscopic findings in women with postmenopausal bleeding in order to assess the causes of PMB and to determine their prevalence in our population.Methods: This was a prospective observation study, comprising of total number of 50 postmenopausal women attending gynae OPD at department of obstetrics and gynecology, Command Hospital (CH), Lucknow, Uttar Pradesh. The data obtained for the purpose of study was fed into computer using Microsoft excel 2013 software.Results: A total of 50 women with complaints of postmenopausal bleeding were enrolled in the study. Maximum number of women had achieved menopause between age 46 and 50 years. Hysteroscopy had an accuracy of 94% for detection of polyps. Hysteroscopy had an accuracy of 90% for detection of atrophy. For fibroid, hysteroscopy had an absolute sensitivity, specificity, positive predictive, negative predictive and accuracy value (100%).Conclusions: The findings of present study suggested that hysteroscopy has a useful role in evaluation of postmenopausal bleeding especially in the diagnosis of polyps and fibroids. Given fewer number of cases, the usefulness of hysteroscopy in evaluation of endometrial cancer and hyperplasia could not be established adequately. Further studies on larger number of sample size will help in providing more useful and confirmatory information.
RESUMO
Background: Cesarean section is the most commonly performed surgery in the department of gynecology. However, it has its own merits and demerits which affect the mother and the baby in the present as well as subsequent pregnancies. There is a rising trend of cesarean deliveries not only in India but worldwide. So, there is a dire need to audit these cesarean sections and make necessary recommendations accordingly to curb the rising incidence of cesarean deliveries in near future. Hence, the present study analysed the leading groups contributing to high cesarean rates at a tertiary hospital of Armed Forces using Robson ten group classification.Methods: This study was conducted in a Tertiary Hospital of Armed Forces at Chandigarh. All patients who delivered in this hospital between January 2016 to December 2018 were included in this study as per the Robson ten group classification.Results: number of patients who delivered during the time period January 2016 to December 2018 was 3136. Number of patients who delivered vaginally during the same period was 1865. Number of patients who delivered through cesarean section were 1271. Group 5 was the leading contributor to cesarean deliveries followed by groups 2 and 4 subsequently. However, there was significant contribution by group10 to the list.Conclusions: Groups 5, 2 and 4 are the leading contributors to cesarean sections at our institute. So, author need to introspect the labour room protocols and change our norms especially about fetal distress based on CTG monitoring and perform versions in mal-presentations if not contra-indicated to reduce cesarean section rates in near future. Even rising rates of cesarean section in elderly primis, patients conceived after infertility treatment and increasing trends of cesarean delivery on maternal request needs to be checked to reduce the rates of primary cesarean sections.