RESUMO
Background: It is well-known since long time the beneficial effects of misoprostol particularly as a cervical softening agent in obstetric practice. Keep in view, study aimed to evaluate the efficacy of vaginal misoprostol 400 mcg before endometrial biopsy in premenopausal women.Methods: All the 200 patients were classified into two groups viz. study group (Group I) with 100 patients and control group (Group II) with 100 patients. To Group I patients, 400 mcg of misoprostol was given vaginally, 4 hours prior to the commencement of endometrial biopsy whereas no medication was received by Group II patients.Results: In the present study, the base line cervical dilatation is found to be 5.8±1.3 mm in Group I patients whereas 3.8±0.92 mm in Group II patients which is significantly higher (p<0.05). Only 32 patients in Group I required further dilatation whereas 88 patients in Group II underwent further dilatation. The mean time required for further dilatation in Group I and Group II patients was 42.6±17.4, 64.6±16.8 sec respectively and was significantly higher in Group II patients (p<0.05). Out of 100 patients in Group I, only 2% of patients complained severe pain whereas in Group II 48% of patients experienced intolerable pain and required anesthesia.Conclusions: Vaginal administration of 400 mcg misoprostol 4 hours prior to endometrial biopsy in premenopausal women had a significant effect on cervical resistance and cervical dilatation.
RESUMO
xBackground: The pregnant women are more commonly affected with asymptomatic bacteriuria (ASB) than non-pregnant women and its progression could lead to adverse maternal and perinatal outcomes. The study was designed with an aim to know the prevalence of ASB and its effects on maternal and perinatal outcome.Methods: In this prospective study, 300 antenatal women attending Anil Neerukonda Hospital were screened for ASB. Urine culture was performed using standardized Kirby-Bauer disc diffusion method on blood agar, Mac Conkey抯 agar for antibiotic sensitivity testing. The screened antenatal women were divided into two subgroups viz. asymptomatic bacteriuria positive (Group I) and asymptomatic bacteriuria negative (Group II) depending on the culture study and were followed till delivery for maternal and perinatal outcomes.Results: The prevalence of ASB was 11.33%. Out of 34 cases of ASB positive, 8 cases (23.5%) were delivered with birth weight <2500 grams as compared to 11 cases (4.1%) in unexposed cases (RR 5.68, 95% CI; 2.46-13.15; p<0.05). Preterm low birth was noticed in 5 (14.7%) cases of ASB positive pregnant women with compared to unexposed cases (RR 1.5, 95% CI; 0.61-3.65, p=0.36). Regarding maternal outcomes, premature labour was observed in 8 cases (23.5%) of ASB exposed women whereas 22 (8.3%) in non-exposed cases (RR 2.84, 95% CI; 1.37-5.88, p=0.004). A significant number of women have developed hypertension (17.6%) and preeclampsia (8.8%) in ASB positive cases as compared to ASB negative cases (4.9% and 2.3% respectively).Conclusions: The prevalence of ASB was 11.33% in the present study. As one third of the cases were identified in early and late trimesters, regular and trimester wise screening need to be incorporated in routine antenatal screening for safe motherhood and new born health.