ABSTRACT
Introduction: The coiling of the umbilical vessels develops by about 28 days post-conception and is present in about 95% of foetuses by around nine weeks of conception. Umbilical coiling (UC) is associated with many maternal and fetal outcomes. The present study attempts to assess any associations between medical disorders of pregnancy with umbilical cord coiling. Methodology: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Gandhi Medical College δ Sultania Zanana Hospital, Bhopal, India, from January to December 2020. A total of 300 obstetric mothers were included in the study. Coiling of the umbilical cord numbers and pattern and umbilical coiling index was assessed at the time of delivery. Medical disorders such as diabetes mellitus, hypertension and thyroid disorders during pregnancy were evaluated at the time of delivery. Data was entered and analysed with Epi info software. Results:Gestational diabetes mellitus was seen in hyper-coiled and normocoiled, but not also in hypocoiled UC. Hypothyroidism with GDM was seen only in hypocoiled UC. A significant association was seen with selected endocrinal medical problems with umbilical cord coiling (P value <0.05). The most common blood pressure-related disorder identified in the present study is eclampsia (66.66%). Gestational hypertension was seen only in hypocoiled UC coiling. Conclusion:The most common endocrine disorder associated with umbilical cord coiling was gestational diabetes in hyper coiled and normocoiled UC. Hypocoiling and normocoiling have been found in medical disorders of pregnancy. Multicentric studies are required to identify the relationship between endocrine and blood pressure-related disorders and umbilical coiling.
ABSTRACT
OBJECTIVE: A prospective cohort study in a teaching hospital to assess the efficacy and safety of neoadjuvant chemotherapy in the treatment of locally advanced carcinoma cervix. METHOD: Neoadjuvant chemotherapy in the form of cisplatin 75 mg/m(2) and paclitaxel 135 mg/m(2) on day 1 and repeated at 14 days' interval for up to a maximum of three courses. RESULTS: Neoadjuvant chemotherapy in cervical cancer was effective in the downstaging of the disease. Downstaging was observed in 19.23 % of patients after two cycles and in 50 % of patients after three cycle of NACT. Operability increases to 33.3 and 38.4 % after two and three cycles of NACT, respectively. Complete pathological response was observed in 37.5 % of patients after NACT. No significant adverse effect in the feasibility of surgery was observed. CONCLUSION: The present study showed that neoadjuvant chemotherapy was an effective and well-tolerated mode of therapy with significantly less morbidity and mortality.
