{"title":"Estimation of fetal weight at term by clinical and sonographic assessment and its correlation with the birth weight – A prospective cohort study in a tertiary care hospital","authors":"Ravichandran Kandasamy, Lal Bahadur Palo, Ravichandran Kandasamy","doi":"10.18231/j.ijogr.2024.050","DOIUrl":"https://doi.org/10.18231/j.ijogr.2024.050","url":null,"abstract":"Estimation of fetal weight is necessary to decide on the time and route of delivery. Different clinical and ultrasound methods for estimating fetal weight are followed by different institutions. Antenatal assessment of fetal weight is necessary to achieve better feto-maternal outcomes. The objectives of this study were: (a) fetal weight estimation by ultrasound (Hadlock’s formula) and clinical methods (Johnson’s formula and Dare’s formula) and (b) to compare them with the actual weight of the baby after birth. A prospective cohort study was conducted in a tertiary care centre at Puducherry, India including all singleton, term pregnant women with vertex presentation, normal AFI and BMI <35 kg/m who delivered within the next 48 hours of assessment. The agreement between the different methods of fetal weight estimation and actual birth weight were calculated using intraclass correlation coefficient. Bland and Altman plot was done to identify the intervals of agreements. A total of 400 term antenatal women with age range of 17 to 44 years participated in the study. Intraclass correlation coefficient for Johnson’s formula was 0.816, Dare’s formula was 0.672 and Hadlock’s formula was 0.912. All the three methods had statistically significant correlation with the actual birth weight. Ultrasound estimation of fetal weight is the best out of the three methods and it correlated well with the actual birth weight. Johnson’s formula also gave results close to actual birth weight. With a correlation coefficient comparable to that of ultrasound estimation, Johnson’s formula can be used in low resource settings where ultrasound facilities are not available.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"10 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140976578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The serum leptin can be a predictable marker for gestational diabetes mellitus","authors":"Vemugadda Harika, Swathy Thilak, Radhakrishan Narayanswamy","doi":"10.18231/j.ijogr.2024.040","DOIUrl":"https://doi.org/10.18231/j.ijogr.2024.040","url":null,"abstract":"This study assessed the serum leptin concentrations for development of gestational diabetes mellitusThis is a case-control study, included 120 participants (60: Gestational Diabetes Mellitus Cases and 60: Healthy Controls). We assed BMI, FBS, HbA1c, Lipid Profile and serum leptin. The serum leptin concentrations were significantly elevated in patients with gestational diabetes mellitus when compared to controls (P=0.001**). There was a significant positive correlation between the serum leptin and BMI, FBS, HbA1c, Total Cholesterol and LDL (P=0.001**). Based on study findings, significant elevated levels of serum leptin might be served as a marker for detection of gestational diabetes mellitus.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"128 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140977472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of Bishop’s score with transvaginal sonographic cerviComparison of Bishop’s score with transvaginal sonographic cervical assessment to predict success of induction of labor","authors":"Subhi Srivastava, Sendhil Coumary A","doi":"10.18231/j.ijogr.2024.053","DOIUrl":"https://doi.org/10.18231/j.ijogr.2024.053","url":null,"abstract":"Induction of labor for medical or obstetric indications is a common practice in modern obstetrics. Evaluation of the cervix by Bishop’s score is universally used to predict the success of induction of labor. But it is a subjective method and many studies have shown that it is not a good indicator of success of induction. To compare Bishop’s scoring system and trans-vaginal sonographic assessment of cervix in predicting the successful outcome of induction of labor.This was an observational study conducted in a tertiary care center. 120 patients who met the selection criteria were included. Prior to the induction of labor the Bishop’s score and the sonographic scoring was assigned. Successful induction was defined as the patient entering the active phase of labor. 84% of participating women entered the active phase of labor. While 72.6% women had a normal vaginal delivery, 67.8% women delivered vaginally within 24 hours of induction. The TVS score (MGPICSS) of ≥2 predicted the successful induction with a specificity of 100% and sensitivity of 39.3% and AUC 0.74. In comparison, the Bishop score of ≥4 had a specificity of 75% and sensitivity of 44% and AUC 0.56. The prediction of delivery within 24 hours at the MGPICSS of ≥2 had a specificity of 100% and sensitivity of 42.9% and AUC 0.76. For the same, the Bishop’s score of ≥4 had specificity of 83.3% and sensitivity of 45.5% and AUC 0.71. TVS assessment of cervix is a better predictor of successful labor induction in comparison to Bishop’s score.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"39 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140975623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unveiling the spectrum of cardiac disease complicating pregnancy: A comprehensive exploration of maternal and fetal outcomes","authors":"Manju Mathesan, H. Kirubamani","doi":"10.18231/j.ijogr.2024.032","DOIUrl":"https://doi.org/10.18231/j.ijogr.2024.032","url":null,"abstract":"Cardiac diseases pose a significant non-obstetrical threat to maternal well-being during pregnancy, contributing to nearly 10% of maternal mortality. The intersection of pregnancy and cardiac disease presents a complex scenario, affecting approximately 1-3% of pregnancies. Rheumatic heart disease (RHD) remains a prevalent issue in developing countries, while advancements in pediatric cardiology have increased survival rates for congenital heart disease. This exploration aims to comprehensively understand the impact of cardiac diseases on maternal and fetal outcomes during pregnancy.A prospective observational study conducted over 1 year and 6 months included 40 pregnant women with cardiovascular disease. Antenatal investigations, electrocardiogram, and echocardiography were performed. Maternal and fetal outcomes were assessed, and data were presented as descriptive statistics. The study revealed a 2.07% prevalence of cardiac disease in 1926 deliveries, with a mean age of 24±4 years. Cesarean section was the predominant mode of delivery (70%). Most cases had NYHA grade I disease (80%). Maternal outcomes were uneventful in 88%, and only 12% had ICU admission. Complications due to cardiac disease were observed in 17.5% of participants. Neonatal outcomes included NICU admission (25%), low birth weight (22.5%), and preterm birth (20%).Cardiovascular complications in pregnancy affect up to 4% of cases. The prevalence in this study aligns with existing literature. Rheumatic heart disease and congenital heart disease were predominant, consistent with global trends. Maternal and perinatal outcomes were favorable in NYHA grades I and II, emphasizing the importance of early intervention and healthcare accessibility.Cardiac disease is a substantial risk factor for maternal mortality during pregnancy. The study highlights the dual risk of balancing maternal well-being and fetal development. Prevalence, complications, and outcomes underscore the significance of pre-pregnancy counseling, early detection, and multidisciplinary management for optimal pregnancy outcomes.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"41 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140974587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Celestine Osita John, Atochi Prince Woruka, Kariba Akhidue, Rosemary Ogu
{"title":"Test characteristics of glycated albumin in the diagnosis of gestational diabetes mellitus","authors":"Celestine Osita John, Atochi Prince Woruka, Kariba Akhidue, Rosemary Ogu","doi":"10.18231/j.ijogr.2024.054","DOIUrl":"https://doi.org/10.18231/j.ijogr.2024.054","url":null,"abstract":"This study determined the test characteristics of glycated albumin in the diagnosis of gestational diabetes mellitus. The gold standard for diagnosing gestational diabetes mellitus is the oral glucose tolerance test which requires patient preparation, drinking of glucose solution, and multiple sample collections. A possible alternative biomarker for the diagnosis of gestational diabetes is glycated albumin does not require patient preparation and only one sample is collected. Glycated albumin levels are higher among Black Americans than in Caucasians.The study involved 200 pregnant women attending the antenatal clinic at the University of Port Harcourt Teaching Hospital. The diagnosis of gestational diabetes mellitus was made using the World Health Organization 2013 diagnostic criteria. The test characteristics of glycated albumin were determined using the area under the curve of the receiver operator characteristic curve, sensitivity, specificity, positive predictive value, and negative predictive value. The prevalence of gestational diabetes mellitus was 9.0%. The area under the receiver operator characteristic curve for glycated albumin was 0.8 (95% CI 0.7-0.9; p=0.0001). The sensitivity and specificity of glycated albumin were 83.3% and 86.8% respectively. The positive predictive value was 38.5% and the negative predictive value was 98.1%. Glycated albumin has high sensitivity, specificity, and negative predictive values and therefore, can be used as a preliminary test for gestational diabetes mellitus.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"34 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140974680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Endometrial thickness by ultrasonography and its correlation with histopathology in abnormal uterine bleeding among peri and post menopausal women","authors":"Pramila Jena, Priti Mishra, Somya Ranjan Panda, Jyochanmati Panda, Sourav Padhee, Sibanarayan Rath","doi":"10.18231/j.ijogr.2024.038","DOIUrl":"https://doi.org/10.18231/j.ijogr.2024.038","url":null,"abstract":"The endometrium constitutes a dynamic organ in female reproductive years, as it is subjected to hormonal variations in every cycle. Present study was conducted with the aim to correlate the endometrial thickness with the histopathology in the peri-menopausal females presenting with abnormal uterine bleeding (AUB) and to identify cut off value of endometrial thickness in order to reach at some consensus regarding when to intervene so that not a single endometrial pathology will be missed.This was an observational study conducted on 242 peri-menopausal and post-menopausal women ≥40 years of age presenting with abnormal uterine bleeding (AUB).: Based on the ROC curve, the cutoff point that delineates the abnormal histology and normal histology for endometrial thickness was 14.20 mm. Area under the curve (AUC) was 0.783 with 95% CI as 0.686 - 0.880 having sensitivity 71% and specificity 90% (p < 0.001). Heavy menstrual bleeding and frequent cycle were found to be commonly associated with gynecological pathology in these age groups. In all post and peri-menopausal AUB trans vaginal sonography for endometrial thickness is the initial best modality of investigation. Endometrial thickness cutoff in the range of ≥ 14 mm is of prime importance.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"137 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140977162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Sharma K. N, Shilpa Umarji, Sai Bhavani Visarapu
{"title":"Construction and validation of self-reporting menstrual disorder screening questionnaire for Indian population","authors":"S. Sharma K. N, Shilpa Umarji, Sai Bhavani Visarapu","doi":"10.18231/j.ijogr.2024.043","DOIUrl":"https://doi.org/10.18231/j.ijogr.2024.043","url":null,"abstract":"Dysmenorrhea is defined as difficulty in menstrual flow and refers to painful cramps during menstruation. There are 2 types of dysmenorrhea, primary and secondary dysmenorrhea respectively. Early diagnosis of these conditions which may be responsible for dysmenorrhea is necessary to curb the rising prevalence of infertility. There are no adequate screening questionnaires available for Indian population which can screen dysmenorrhea and differentiate primary and secondary dysmenorrhea.: The objective of phase-1 of this study comprised of constructing menstrual disorder screening questionnaire and content validating the questionnaire and the objective of phase-2 was to administer the developed questionnaire on the targeted population. This was a cross-sectional study in which a questionnaire was developed and content validated by experts. The expert panel was asked to validate each question on a four-point Likert scale for relevance, clarity, ease of comprehension and the question was represented in participants correct section. A pilot study was carried out on 31 participants. A total of 142 participants were participated in the study.Dysmenorrhea was reported by a total of 129 participants i.e. 90.85% whereas only 9.15% reported of having no pain during menstruation. Dysmenorrhea symptoms experienced only sometimes by 56 participants, but 73 participants reported to experience them with each cycle. The questionnaire developed, and content validated in this study can be used as a self-reporting screening tool to detect menstrual abnormalities in the Indian population","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"48 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140974664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A comparative study between dinoprostone pessary and dinoprostone gel for induction of labor and neonatal outcome","authors":"Pranjali Rai, Rashmi M D","doi":"10.18231/j.ijogr.2024.035","DOIUrl":"https://doi.org/10.18231/j.ijogr.2024.035","url":null,"abstract":"This study compares the safety and efficacy of two dinoprostone formulations – a pessary and a gel. A retrospective randomised observational study was conducted to compare Dinoprostone controlled release pessary and Dinoprostone gel for induction of labor at term in women with unfavourable cervix at Apollo Hospitals BGS, Mysuru during August 2018 – May 2020. Among study participants 50 expectant mothers received Dinoprostone pessary while 50 women received Dinoprostone gel for induction of labour. Both groups were compared and the outcomes were analysed. The primary outcomes of the study were induction to delivery interval, successful vaginal delivery, need for operative vaginal delivery and need for caesarean section. Secondary outcomes were observed for neonatal morbidity and uterine hyperstimulation. There was a significant (p=<0.001) improvement in Bishop scores after induction in both groups. When only the post-induction scores for the two formulations were compared, the pessary helped to improve the bishops score (or helps in cervical ripening) better than the gel formulation and therefore can help to improve the chances of vaginal delivery(because there is a significant change in post induction bishop score in pessary group). The mean interval from induction to delivery for the pessary group was 11.03±4.648 hours and for the gel it was 21.18±9.127 hours with a significant p value <0.005The pessary showed a significant improvement in the post-induction Bishop score and a shorter induction to delivery time compared to the gel. Differences in the mode of delivery were not significant. Fortunately, no serious side effects to the mother or fetus were observed with both products. Both formulations of dinoprostone are safe for induction of labor at term. However, pessary achieves comparitively a higher rate of spontaneous vaginal delivery with a shorter labor induction time. Ease of administration, single application and thus decreased chance of infections are its additional benefits.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"65 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140973339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Parekh, Bijal M. Patel, Pariseema S. Dave, Prabhudas Patel, R. Arora
{"title":"Prevalence and distribution of HPV 16 and 18 with its epidemiological profile among cervical cancer patients: A prospective study from regional cancer centre of Gujarat, Western India","authors":"C. Parekh, Bijal M. Patel, Pariseema S. Dave, Prabhudas Patel, R. Arora","doi":"10.18231/j.ijogr.2024.048","DOIUrl":"https://doi.org/10.18231/j.ijogr.2024.048","url":null,"abstract":"Cervical cancer (CC) is the leading cause of morbidity and mortality due to cancer among women in Indian. This study was conducted to determine the prevalence and distribution of HPV16/ 18 and epidemiological profile of CC patients from, Gujarat Western India.CC biopsy specimens of 400 patients were analyzed for HPV16 and 18 by type-specific PCR. In our study 74% of CC cases were positive for HPV, 67% had HPV16, 14.8% had HPV18 and 7.7% had both HPV16/18. The median age of the women with CC was 50 years and peak incidence (31.8%) was between 40 to 50 years. Majorities (68.5%) were postmenopausal. The median age of marriage was 20years. Squamos cell carcinoma (SCC) was found in 91% and adenocarcinoma (ADC) in 7.3% of the patients. As per study 7.8%, 16.3%, 58% and 2.5% of CC patients presented in FIGO stage I, II, III, and IV respectively. HPV16 was exhibited in, 68.8% and 66.4%, HPV18 in 14.9% and 15.9% of pre and postmenopausal patients respectively. HPV16 and HPV 18 positivity was 68.7% and 51.7% and 13.2% and 31% in SCC and in ADC respectively. HPV16 infection was higher in stage I and HPV18 in stage IV malignancy.There were two peaks of HPV16, first between 21 to 30 and second between 51 to 60 years among CC patients. HPV 16 is highly prevalent among all groups. In patients with adenocarcinoma, Stage IV malignancy & who had marriage before 18years, incidence of HPV18 was relatively high.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140973582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amrita Saxena, Swati Kumari, V. Aditya, Najma Malik, H. Tiwari
{"title":"A comparative interventional study on fixed-dose versus titrated- dose oral misoprostol solution for induction of labour at term gestation in a tertiary care centre of Eastern Uttar Pradesh","authors":"Amrita Saxena, Swati Kumari, V. Aditya, Najma Malik, H. Tiwari","doi":"10.18231/j.ijogr.2024.049","DOIUrl":"https://doi.org/10.18231/j.ijogr.2024.049","url":null,"abstract":"Induction of labor entails the deliberate initiation of uterine contractions before the spontaneous onset of labor, irrespective of whether the amniotic membranes have ruptured or not. The Modified Bishop’s score of six or higher indicates that the cervix is ripe, or “favorable” – when there is a high likelihood of spontaneous labor or responsiveness to interventions designed to induce labor. Misoprostol being cost-effective, easily available and stable at room temperature makes itself a promising agent in future for induction of labour if the feto-maternal safety concerns are proved with evidence. The aim of our study was to compare the efficacy of titrated versus fixed dose oral misoprostol solution regimen as inducing agents and the effects on fetomaternal outcome.A comparative interventional study was conducted for one year and study population consisted of term pregnant women admitted to the labour room of the hospital. A total sample size of 150 was deemed necessary, with 75 participants required per group. Following allocation into groups, induction of labor was carried out using either oral titrated-dose misoprostol solution or fixeddose misoprostol solution.Successful induction of labour was higher in fixed -dose group (Group F) (80%) as compared to 65.53% in titrated-dose group (Group T), the difference was statistically significant (p=0.0439). The need for augmentation was lower in group F (30.67%) than in group T (56%). Statistically, this difference was significant (p = 0.0017). Uterine hyper stimulation and atonic post-partum haemorrhage were noted more in group T but this difference was not significant (p = 0.1461; p = 0.3108). Requirement of newborn resuscitation was observed higher in group T [34 (45.34%)] than group F [16(21.33%)]. Statistically, this difference was significant [p=0.0081]. NICU admissions were more in group T (21.34%) than group F (13.33%), but difference was not significant (p = 0.0574).This study concludes that both fixed- dose and titrated-dose oral misoprostol solution regimens are effective in induction of labour but fixed-dose regimen has an advantage of less mean total dose of misoprostol administered, reduced induction to delivery interval, less uterine hyperstimulation, atonic postpartum hemorrhage and better fetomaternal and neonatal safety profile.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"140 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140976646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}