A study on obstetric patients with corona virus infection requiring critical care

Background: Coronavirus cause respiratory tract infection that can range from mild to lethal like cold, fever, cough, shortness of breath, fatigue, chills, body aches, headache, sore throat, loss of smell or taste, nausea, diarrhoea, pneumonia, respiratory failure, septic shock and death. The purpose of this study was to describe the clinical manifestations of obstetric patients with COVID-19 infection requiring critical care, their 02 requirements, complications, co-morbidities associated and mortality related to it.Methods: A study was conducted in the Department of Obstetrics and Gynecology, Cama and Albless hospital, Mumbai including 31 patients with SARS CoV-2 infection requiring critical care. Necessary information such as their detailed clinical, and obstetric history, clinical examination, investigations was noted.Results: In our study, the most common symptoms were shortness of breath, followed by fever. PIH was the most common co morbidity associated and pneumonia as most common complication. Anemia, thrombocytopenia and NLR>4 were found more common in intensive care unit (ICU) admitted patients as compared to non-ICU admitted patients. 77.4% of patients had abnormal chest X-ray with 25.8% requiring mechanical ventilation.Conclusions: COVID 19 infection is affecting pregnant women resulting in mild to lethal disease. Most of pregnant women are asymptomatic or have mild disease but some of them require critical care. These women should be monitored carefully to prevent maternal morbidity and mortality.

Study of choices of contraception in postpartum women in a tertiary care institute in Mumbai, Maharashtra, India

Background: This modern era talks about women strength and empowerment where they are working either equally or one step ahead of men. However, a fall back in making decisions for contraception use and family planning can still be observed. It is most frequently seen among women belonging to some village as they are exposed to a minimal health care. Keeping this in mind, this crucial period was considered as opportunity to test the issue regarding the various choices of contraception available. Objective of this study was to find out the criteria and methods of contraception selected by women in the postpartum period.Methods: A cross-sectional study in the department of obstetrics and gynaecology was conducted over a period of 11/2 years in which a total of 150 postpartum women were interrogated and counselled regarding various methods of contraception.Results: The contraceptive methods most commonly selected in postpartum period are PPIUCD, Barrier, tubal ligation and injectable contraception of which condom is the most common method adopted. The important factors responsible for the choice of contraception include parity, breast- feeding, education and socio-economic status of the women.Conclusions: Postpartum period is particularly important for initiating contraception as the largest proportion with unmet need of contraception is found among those in their first year after child birth. In order to space birth in a healthy manner postpartum contraception should be emphasized upon.

Study of incidence of premature ovarian failure in patient attending outpatient department for infertility in a tertiary care centre

Background: To assess the incidence of premature ovarian failure in cases attending infertility outpatient Department of Obstetrics and Gynecology in a tertiary care centre. A total of 350 patients attending infertility opd were screened over period of 150 days from which authors observed premature menopause in 10 cases accounting for an incidence of 2.8%. POF affects approximately one in 10,000 women by age 20; one in 1,000 women by age 30; one in 100 women by age 40.  Premature ovarian failure is a common cause of infertility in women.Methods: Patient attending outpatient Department of Obstetrics and Gynecology with age less than 40 years and infertility, symptoms of menopause were enrolled for the study for duration of 150 days.Results: Present study authors found a total of 2.8% of patient presenting in our outpatient department for infertility had Premature ovarian failure.80% of them were symptomatic suffering with symptoms of hormonal deficiencies .100% of patient with infertility diagnosed as premature ovarian failure had low AMH and High FSH and LH levels indicating poor prognosis.Conclusions: Patient presenting with infertility and amenorrhoea can be cases of premature menopause. Here it is essential to investigate and treat the patient. Infertility might be one of the early presenting symptoms if not the first one. These patients if treated and diagnosed early can have a better living. Considering the wide spectrum of functional derangements in patient with early menopause and benefits of early hormone replacements these patients should be diagnosed and treated early.

Study Of Etiological Factors Of Female Infertility In A Tertiary Care Medical College And Hospital

Infertility is traditionally described as inability of a couple to conceive after one year of unprotected intercourse. Although the original definition still stands, recent evidence suggests that the definition should be more relaxed and should include couples who, within the period of one year, already have recognised pathology which may cause difficulty in conception. Newer guidelines define infertility as failure to conceive after 1 year of unprotected intercourse, and in women over 35 years of age within 6 months of unprotected intercourse. Infertility is turning out to be the one of the most common reason for women attending the Gynecology OPD. This study was undertaking with the aim of identifying the most common causes of infertility in women attending the Gynecology OPD at a tertiary care hospital in a tier 3 metro city.

Factors Predicting Success of Trial of Labour among Women with Previous one Caesarean Delivery in a Developing Country.

The objective of the study was to find out the factors predicting outcome of trial of labour after previous caesarean delivery among women living in a developing country. A retrospective study of 149 cases of trial of Labour was conducted in women with a history of one prior caesarean section. Binary logistic regression was used to identify predictive factors. The adjusted odds ratios with 95% confidence intervals (95%CI) were used to indicate risk of failure of the trial of Labour when the factor was present. It was found that success rate of vaginal birth was 24.16%. Factors significantly predictive of success of trial of Labour were previous vaginal delivery (OR 18.4, 3.3 -329.6), baby weight < 3 kg (OR 33.3, 5.4-62.6) and 2nd stage of labour during previous LSCS (OR 2.1, 1-4.2). The study has shown that trial of labour can be attempted successfully, in women with previous caesarean delivery, with due consideration of maternal and foetal outcome. A prior history of vaginal delivery and baby weight < 3 kgs are the best predictor of success of trial of labour.