Bangladesh Journal of Obstetrics & Gynaecology最新文献

{"title":"Nonsurgical Management of Mullerian Agenesis with Saline Injection and Sustained Digital Pressure: A Case Series","authors":"Shakeela Ishrat, F. Deeba, S. A. Anwary, J. Banu, P. Fatima","doi":"10.3329/bjog.v36i1.65982","DOIUrl":"https://doi.org/10.3329/bjog.v36i1.65982","url":null,"abstract":"When a woman with mullerian agenesis presents with blind or absent vagina, management options include surgical vaginoplasty or non surgical self dilatation. Vaginal dilation should be the first line management of mullerian agenesis. Because of the need for motivated, mature patients and long term dilatation and follow up, gynecologists usually go for surgical vaginoplasty. We tried a novel approach to nonsurgical dilation of vagina in the cases of mullerian agenesis. We injected normal saline into the potential space of vagina between urethra and rectum and applied digital pressure daily for 14-15 days. This procedure created a vaginal space which was to be further dilated by regular coitus and/ or vaginal dilators. We are presenting here a series of three cases of mullerian agenesis managed by non surgical vaginal dilatation, facilitated by prior saline injection and sustained digital pressure. \u0000Bangladesh J Obstet Gynaecol, 2021; Vol. 36(1): 65-68","PeriodicalId":337805,"journal":{"name":"Bangladesh Journal of Obstetrics & Gynaecology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114335379","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":"Medical Management of Incomplete Abortion Using Pervaginal Misoprostol in Chittagong Medical College Hospital","authors":"Zakia Mamataz, Suman Nazmul Hosain, Sulekha Bhattacharjee, Jahanara Aktar, R. Akhtar","doi":"10.3329/bjog.v36i1.65937","DOIUrl":"https://doi.org/10.3329/bjog.v36i1.65937","url":null,"abstract":"Background: A miscarriage is a pregnancy that ends before the baby can survive outside the womb because it has not yet reached viability. A miscarriage may be early - during the first 14 weeks of pregnancy, or late. Objective of the study was to see the outcome of pervaginal misoprostol in the medical management of incomplete abortion. \u0000Methods: This cross-sectional study was performed between July and December 2015 on patients with incomplete abortion, who wanted to undergo medical management at the Department of Gynecology and Obstetrics, Chittagong Medical College Hospital. 100 consecutive incomplete abortion cases, who fulfilled the inclusion and exclusion criteria were enrolled for the study. Information about management with per vaginal misoprostol, possible side effects and success rate was given to the women. 600 microgram misoprostol was given per vaginally. Interval between administration of misoprostol and expulsion of product of conception was recorded. \u0000Result: The mean age was found 25.0±6.4 years and the mean gestational age was found 10.2±2.0 weeks. The mean duration of bleeding was found 8.6±10.9 days. No side effect was found in 86 (86%), nausea in 7(7%), vomiting in 5 (5%) and cramping in 2 (2%) patients. For majority (76%) of the patients, single dose of Misoprostol was enough to achieve the goal. However, 24 patients didn’t respond and received a second dose. The mean induction expulsion interval was 10.83±5.45 hours. Retained product of conception was found in 14 patients. Medical management failed in these 14 patients and ultimately Dilatation & Curettage (D & C) was done. \u0000Conclusion: Pervaginal Misoprostol is as effective as method of treating incomplete abortion at uterine size of <12 weeks. Treatment with misoprostol can reduce the demand for surgical evacuation in cases of incomplete abortion. The acceptability of misoprostol appears higher. Pervaginal Misoprostol appears suitable for the treatment of incomplete abortion in the developing countries. \u0000Bangladesh J Obstet Gynaecol, 2021; Vol. 36(1): 42-48","PeriodicalId":337805,"journal":{"name":"Bangladesh Journal of Obstetrics &amp; Gynaecology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132542751","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 Prospective Randomized Study between Laparoscopically Assisted Vaginal Hysterectomy and Total Laparoscopic Hysterectomy in a Tertiary Care Hospital","authors":"K. Nessa, F. Dewan, Afsana Haque Chodhury, Mariha Alam Chowdhary","doi":"10.3329/bjog.v36i1.65932","DOIUrl":"https://doi.org/10.3329/bjog.v36i1.65932","url":null,"abstract":"Introduction: Hysterectomy is one of the most common gynecological surgeries conducted worldwide. Total Laparoscopic Hysterectomy (TLH) and Laparoscopy Assisted Vaginal hysterectomy (LAVH) have been the mainstays of hysterectomy procedures. When compared with Total Abdominal Hysterectomy (TAH) and LAVH, TLH has been reported to result in shorter durations of procedure, lower blood losses, and shorter hospital stays.Therefore the present study was conducted to compare between operative outcome of LAVH and TLH. \u0000Objectives: To compare the surgical outcomes of laparoscopically assisted vaginal hysterectomy, and total laparoscopic hysterectomy in a tertiary care hospital and to determine the challenges of the two methods in terms of cost, logistic supports and need for trained manpower. \u0000Study design: A prospective, randomized study was performed at a tertiary care center between January 2019 to January 2020. A total of 50 women indicated to undergo hysterectomy for benign uterine disease were randomly assigned to two groups (25 LAVH, and 25 TLH). The randomization procedure was based on a computer-generated list using serially numbered, opaque, sealed envelopes. A blinded physician randomly assigned each patient to either LAVH (n = 25) or TLH (n = 25). The sequence was concealed until interventions were assigned. Those who performed surgical procedures did not know which patients undergoing surgery had been included in the study. Those assessing the outcomes were blinded to the group assignments. Outcome measures, including operating time, blood loss, rate of complications, level of Hb before and after surgery, need of blood transfusion, consumption of analgesics, and length of hospital stay, were assessed and compared between groups. \u0000Results: There were no differences in baseline demographics between the two groups. The TLH group required shorter operating time than the LAVH group. The estimated blood loss was significantly more in the LAVH group than the TLH group. Postoperative hospital stay was slightly more in the LAVH group than the TLH group. Complication rate were similar between the two groups. Three cases in the TLH group needed conversion. Two cases needed conversion to LAVH and 1 case was converted to TAH, all were related to a large lower uterine segment prohibiting visualization during colpotomy. No statistical significant difference was found in regards of postoperative outcome between groups. \u0000Conclusions: TLH and LAVH are both safe, feasible procedures with similar surgical outcomes. TLH was associated with shorter operating time and per operative blood loss, whereas LAVH may be preferred in patients with a uterus with a large lower uterine segment. TLH needs more advanced logistic support and more trained manpower in comparison to LAVH. Cost is higher in TLH group than LAVH group. \u0000Bangladesh J Obstet Gynaecol, 2021; Vol. 36(1): 18-22","PeriodicalId":337805,"journal":{"name":"Bangladesh Journal of Obstetrics &amp; Gynaecology","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115347208","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":"Society News Vol. 36(1)","authors":"S. Tasnim","doi":"10.3329/bjog.v36i1.65987","DOIUrl":"https://doi.org/10.3329/bjog.v36i1.65987","url":null,"abstract":"Abstract not available \u0000Bangladesh J Obstet Gynaecol, 2021; Vol. 36(1): 77-81","PeriodicalId":337805,"journal":{"name":"Bangladesh Journal of Obstetrics &amp; Gynaecology","volume":"12 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125647384","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":"Obstetric Concern, Management and Considerations in the Context of COVID-19 Pandemic","authors":"Nadira Haque, N. Hosain, G. Ara, B. Nasrin, N. Fatema, Yeshey Dorjey","doi":"10.3329/bjog.v36i1.65975","DOIUrl":"https://doi.org/10.3329/bjog.v36i1.65975","url":null,"abstract":"Coronavirus disease (COVID-19) has emerged as a global threat. The disease largely attacks adults with higher mortality among the aged and compromised people. Although previous coronavirus havocs caused significant number of maternal and neonatal demise, most pregnant cases with COVID-19 infection are either asymptomatic or with mild symptoms only. This pandemic brought significant disruption of essential antenatal and intranatal care worldwide. The health resources became diverted to focus on general population needs rather than the specified needs of pregnant women. Limited information is known about the effect of COVID-19 disease on pregnancy. Recent evidence indicates that pregnant women are not vulnerable group for severe COVID-19 illness. However, immunological and physiological alterations during pregnancy expose women more vulnerable to SARS-CoV- 2 infection in comparison to general population.Covid-19 pandemic has created a global crisis causing great challenges for pregnant women and their obstetricians. Although the due course of pregnancy is not strained by the disease itself but complications can happen in absence of proper care and caution. Both the pregnant mother and care-giver should be vigilant and the obstetric management should be implemented following evidence based standard protocol. \u0000Bangladesh J Obstet Gynaecol, 2021; Vol. 36(1): 49-56","PeriodicalId":337805,"journal":{"name":"Bangladesh Journal of Obstetrics &amp; Gynaecology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115096612","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":"Abstracts Vol. 36(1)","authors":"S. Tasnim","doi":"10.3329/bjog.v36i1.65985","DOIUrl":"https://doi.org/10.3329/bjog.v36i1.65985","url":null,"abstract":"Abstract not available \u0000Bangladesh J Obstet Gynaecol, 2021; Vol. 36(1): 74-76","PeriodicalId":337805,"journal":{"name":"Bangladesh Journal of Obstetrics &amp; Gynaecology","volume":"158 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133192026","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":"Robert’s Uterus, Rare Uterine Anomaly: A Case Report","authors":"Shakeela Ishrat, Iva Rani Nandi, J. Banu","doi":"10.3329/bjog.v35i2.58799","DOIUrl":"https://doi.org/10.3329/bjog.v35i2.58799","url":null,"abstract":"Roberts uterus is an extremely rare variety of congenital mullerian duct anomaly. It is also known as asymmetric septate uterus. The uterine septum is complete and fused with uterine wall on one side dividing the cavity into two: one non-communicating and another communicating with cervix. Regular menstrual flow occurs from the communicating cavity. At the same time, obstruction to menstrual flow in one cavity results in formation of hematometra, sometimes hematosalpinx and endometriosis. Presenting symptoms are severe dysmenorrhea and abdominal pain.Imaging modalities like three dimensional ultrasonography or magnetic resonance imaging are useful in diagnosing the mullerian duct anomaly. Traditionally the condition has been treated by laparotomy followed by complete excision of the obstructed one sided cavity. In recent years, incision of septum has been done by hysteroscopy, resulting in a uterine cavity with better reproductive outcome. Here presented the case of a 19 year old woman with Robert’s uterus. The imaging modalities failed to diagnose the case. The anomaly was explored by laparoscopy and hysteroscopy followed by laparotomy. The obstructed hemi-cavity had thick altered blood. It was obliterated following excision of endometrium. The woman was relieved of pain thereafter. \u0000Bangladesh J Obstet Gynaecol, 2020; Vol. 35(2): 125-129","PeriodicalId":337805,"journal":{"name":"Bangladesh Journal of Obstetrics &amp; Gynaecology","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123616505","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":"Histopathological Study of Endometrium in Postmenopausal Bleeding","authors":"F. Ferdous, F. Begum, N. Sultana, Tahrina Akter","doi":"10.3329/bjog.v35i2.58796","DOIUrl":"https://doi.org/10.3329/bjog.v35i2.58796","url":null,"abstract":"Background & objectives: Postmenopausal bleeding is frequent in gynecology and occurs approximately in 5% to 10 % of postmenopausal women. About 10% women with postmenopausal bleeding have a primary or secondary malignancy. Common malignancies among them are endometrial or cervical carcinoma and rarely, ovarian cancer. The incidence of malignancy in postmenopausal period remains sufficiently high, so it requires immediate investigations for early diagnosis, prompt treatment and vigilant follow up. The objective of the present study is to evaluate the causes of postmenopausal bleeding based on histopathology of endometrium and the percentage of various benign, premalignant and malignant lesions in patients with post-menopausal bleeding. \u0000Methods: A retrospective study was undertaken on 78 women presenting with postmenopausal bleeding in Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic disorders (BIRDEM) Hospital, Dhaka, from July 2018 to June 2019. Histopathological reports and patient’s profile were reviewed. Causes of bleeding were identified and related to patients’ age. \u0000Results: Among of 78 cases of postmenopausal bleeding, we found 8 cases of cancer (10.26%). Among them 2 cases were cancer of uterine cervix and 6 cases were cancer of uterine corpus. Benign pathology was more frequent (63 cases: 80.77%), essentially presented with endometrial hyperplasia without atypia 20.52% cases, endometrial polyp 16.67% cases, cervical polyp 14.11% cases, leiomyoma found in 9% cases and preinvasive disease about 9% cases. Histopathological findings in 2 cases of carcinoma cervix were invasive squamous cell carcinoma and 6 cases of endometrial cancer were endometrial adenocarcinoma. Cancer increased with increasing age while the incidence of bleeding decreased with age. \u0000Conclusion: Despite the fact that benign pathology is more frequent than malignancy as a cause of postmenopausal bleeding, we must always rule out a cancer by endometrial and cervical biopsy. \u0000Bangladesh J Obstet Gynaecol, 2020; Vol. 35(2): 112-116","PeriodicalId":337805,"journal":{"name":"Bangladesh Journal of Obstetrics &amp; Gynaecology","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124055623","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":"Doppler Velocimetry of Umbilical Artery in Normal and Growth Restricted Pregnancy","authors":"Zakia Afroze, R. Begum","doi":"10.3329/bjog.v35i2.58787","DOIUrl":"https://doi.org/10.3329/bjog.v35i2.58787","url":null,"abstract":"Objectives: To evaluate the umbilical arterial blood flow velocity and its various indices during 3rd trimester of pregnancy and to compare these indices in normal and growth restricted pregnancies. \u0000Methods: In this study, 50 women with normal singleton pregnancy and 50 women with intrauterine growth restricted (IUGR) pregnancy with expected birth weight <10th percentile of the normal for the gestational age were studied by Doppler evaluation of their umbilical artery, Pulsality Index (PI), Resistance Index (RI) and S/D ratio of the control group and IUGR group were calculated and reference range constructed. Values of Doppler indices of IUGR group were compared with those of the control group. Perinatal outcome was evaluated in relation to the indices. \u0000Results: Doppler velocimetry of umbilical artery showed elevated indices in 33 out of 50 cases of IUGR group showing its high sensitivity in diagnosing haemodynamically compromised growth restricted fetuses. Absent end diastolic velocily (AEDV) and reversed end diastolic velocily (REDV), were seen in 8 and 2 cases respectively and were associated with poor perinatal out come in terms of need for LSCS for fetal distress, Apgar score <7 at 1 minute, admission to NICU (Neonatal Intensive Care Unit) and perinatal death. \u0000Conclusion: In normal pregnancy there is gestational age related fall in impedance in Umbilical arteries. Doppler study of umbilical artery is highly sensitive in the detection of IUGR and for the prediction of adverse perinatal outcome in small for gestational age. \u0000Bangladesh J Obstet Gynaecol, 2020; Vol. 35(2): 68-73","PeriodicalId":337805,"journal":{"name":"Bangladesh Journal of Obstetrics &amp; Gynaecology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131762621","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":"Ovarian Dermoid Cyst- Management by Laparoscopy Versus Laparotomy","authors":"J. Jerin, S. Jahan, F. Begum","doi":"10.3329/bjog.v35i2.58795","DOIUrl":"https://doi.org/10.3329/bjog.v35i2.58795","url":null,"abstract":"Background: Benign cystic teratoma or dermoid cysts are germ cell tumour of the ovary which accounts for 20-25% of all ovarian tumour and are bilateral in 10-15% of cases. These tumour have a low incidence of malignancy, reported as 1-3%. The aim of the study is to determine the safety and efficacy of the laparoscopic management of ovarian dermoid cyst over laparotomy. \u0000Methods: This prospective study was conducted in the Department of Obstetrics and Gynaecology, BIRDEM-II General Hospital, from January 2013-December 2018. During the study period, a total of sixty subjects were included for comparison. Thirty patients were selected for laparoscopic ovarian cystectomy and another thirty patients were selected for laparotomy. They were randomly selected for the procedures. \u0000Result: Thirty patients with ovarian dermoid cyst undergoing laparospic surgery were compared with thirty patients with ovarian dermoid cyst undergoing laparotomy in respect to selection criteria, surgical procedures, operation time, blood loss, hospital stay and outcome of operation. Although the operation time for ovarian cystectomy performed by laparoscopic surgery was slightly longer (62.15 ± 16.3 min, mean ± SD) than by laparotomy (50 ± 16.20 min, p < 0.52), blood loss is smaller and hospital stay is shorter in laparoscopic group than laparotomy. \u0000Conclusion: The laparoscopic approach is generally considered to be the gold standard for the management of dermoid cyst. We believe that laparoscopic management of dermoid cyst may be a safe and beneficial procedure when performed by experienced surgeon. \u0000Bangladesh J Obstet Gynaecol, 2020; Vol. 35(2): 107-111","PeriodicalId":337805,"journal":{"name":"Bangladesh Journal of Obstetrics &amp; Gynaecology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125155911","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}