A study of maternal outcome in first trimester bleeding

Background: The outcome of first trimester vaginal bleeding is a matter of debate. Vaginal bleeding is common and potentially alarming symptom in early pregnancy. First trimester bleeding is a common occurrence. It has been estimated to occur in 15-25% of all pregnant women. Objective of this study was to evaluate the various maternal outcomes in women with first trimester bleeding.Methods: This prospective observational study was conducted in the postgraduate department of obstetrics and gynecology, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India. The study included 200 pregnant women presented with first trimester bleeding. All the women were followed prospectively till delivery and early postpartum period for various outcomes such as preterm delivery, PROM, PPROM, anemia, oligohydramnios, placental abruption, placenta previa and postpartum hemorrhage.Results: Out of 200 patients studied, 19% patients aborted. Ectopic and molar pregnancy was seen in 5% and 1.5% patients respectively. Out of 74.5% patients who continued pregnancy, maternal complications included anemia (52%), PROM (14.09%), oligohydramnios (6.71%), placenta previa (5.37%), PPH (4.03%), PPROM (2.68%), preeclampsia (2.01%), gestational hypertension (1.34%), abruption and post-datism (0.67% each).Conclusions: From the results of this study, it can be concluded that first trimester bleeding can be a predicting factor in terms of mother and infant consequences of pregnancy and it is necessary to increase the knowledge of pregnant women in this regard for closer care.

DNA base excision repair genes variants rs25487 (X-ray repair cross-complementing 1) and rs1052133 (human 8-oxoguanine glycosylase 1) with susceptibility to ovarian cancer in the population of the Jammu region, India

Background: Ovarian cancer is highly prevalent in the population of Jammu, in India; the ovarian cancer ranks third among other types of cancer prevalent in females. However, association studies on ovarian cancer are lacking in this region. We aimed to investigate the disease susceptible variants rs1052133 (human 8-oxoguanine glycosylase 1 [hOGG1]) and rs25487 (X-ray repair cross-complementing 1 [XRCC1]) with ovarian cancer in population of Jammu, India. Materials and Methods: The study conducted in the Shri Mata Vaishno Devi University is a 3-year study which included a total of 280 well-characterized samples (130 ovarian cancer cases and 150 healthy controls). hOGG1 and XRCC1 polymorphisms were determined by polymerase chain reaction-based restriction fragment length polymorphism, and these genotyping results were confirmed by Sanger sequencing. Hardy–Weinberg equilibrium for both single-nucleotide polymorphisms (SNPs) was assessed using the Chi-square test. The allele and genotype-specific risks were estimated by odds ratios with 95% confidence intervals. Results: In this preliminary study, SNP rs1052133 showed protection with ovarian cancer (P = 0.042). The SNP rs25487 was not found associated with ovarian cancer (P = 0.271). Conclusion: Our results indicate that the G allele of rs1052133 imparts protection to the population whereas variant rs25487 was not associated with ovarian cancer in population from the Jammu region, indicating that larger sample size is needed for further statistical validation. Further, association of other SNPs in these genes should also be carried out as their role cannot be ruled out.

Role of laparoscopy in the diagnosis and management of benign adnexal masses

Background: Adnexal masses are frequent findings in women of all age groups. It consists of the ovaries, fallopian tubes and uterine ligaments. Women can present with various gynaecological complaints and adnexal masses could be detected while examining and investigating for these complaints. The aim was to study the role of laparoscopy in diagnosis and management of benign adnexal masses.Methods: The study was conducted on 48 women of reproductive age group. Per speculum examination was done and PAP smear was taken before bimanual examination was done. A complete per vaginum examination was done and the adnexal mass was assessed for its size, side, consistency, laterality and tenderness. Laparoscopy was done to confirm preoperative diagnosis and appropriate procedure done depending on diagnosis.Results: Pain in the lower abdomen was the commonest chief complaint seen in 87.5% cases. 41.67% cases were suspected to have endometriosis while on laparoscopy it was seen in 47.92%, 33.33% were suspected to have ovarian cyst which decreased to 25% on laparoscopy, ectopic pregnancy in 16.67% cases both pre-operative and on laparoscopic examination and tubo-ovarian mass in 8.33% cases pre-operatively and 2.08% on laparoscopy.Conclusions: This study has shown that if proper preoperative evaluation was done, author can select the appropriate patients for laparoscopic approach.