Journal of Obstetrics and Gynecology of India最新文献

{"title":"Obstructive Uropathy Secondary to Pelvic Endometriosis: A Scary Story!","authors":"Aruna Tantia, Kalyani Barde, Gotam Pipara, Ruchi Pipara, Shashi Khanna","doi":"10.1007/s13224-025-02134-4","DOIUrl":"10.1007/s13224-025-02134-4","url":null,"abstract":"<p><strong>Introduction: </strong>Endometriosis presents as-1. superficial, 2. ovarian endometrioma, and 3. deep infiltrating endometriosis. Obstructive uropathy can rarely result from endometriosis, especially in premenopausal women-incidence being 0.3%-12%.</p><p><strong>Case: </strong>A 40-year-old married, working female presented to ER with severe left-sided flank pain radiating, lump abdomen, heavy menstrual bleeding, and inability to pass urine. Physical examination revealed a large 24-week lump abdomen. Imaging studies were done with USG showing a large cystic left adnexal mass which was followed by CT urography showing hydroureteronephrosis and a large cystic mass of 10 cm compressing the urinary bladder and ureter, along with uterine adenomyosis. Emergency cystoscopy and left DJ stenting was done to relieve the obstruction which resulted in relief from flank pain. This was followed by laparoscopic hysterectomy with left salpingo-oophorectomy with right salpingectomy and adhesiolysis. Postoperative imaging showed complete resolution of ureteral obstruction and hydronephrosis. Histopathology confirmed endometriotic cyst and adenomyosis.</p><p><strong>Discussion: </strong>Endometriosis can present with a wide spectrum of symptoms. Involvement of the urinary system in cases of endometriosis might result in compromise of renal function over time. Prompt surgical management is essential in cases of obstructive uropathy. Cases similar to ours have demonstrated the importance of prompt decompression of urinary tract by emergency DJ stenting followed by definitive surgical management of underlying endometriosis. Modern endometriosis management included the conservative laparoscopic surgery and ureterolysis followed by the resection of concomitant endometriosis and a broad-based multidisciplinary approach, centered on a patient's symptoms and priorities.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering endometriosis as a differential diagnosis of women presenting with urological symptoms as well as the need for collaboration between urologist and gynecologist in such cases solidifying that the rapid intervention and multidisciplinary line of management is essential for optimal patient outcome.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 5","pages":"438-441"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Bipolar Transurethral Resection of Bladder Tumor in Pregnancy: A Case Series and Review of Literature.","authors":"Sajad Ahmad Para, Shayista Gull, Faiz Manzar Ansari","doi":"10.1007/s13224-025-02161-1","DOIUrl":"10.1007/s13224-025-02161-1","url":null,"abstract":"<p><strong>Introduction: </strong>Bladder malignancy is uncommon during pregnancy, and there is paucity in the literature about the optimal management. Endoscopic procedures and use of energy sources within bladder always pose a significant risk to pregnancy. Bipolar transurethral resection of bladder tumor allows precise resection, minimizes collateral damage and allows complete resection of tumor. In this retrospective study, we analyze the safety and efficacy of bipolar transurethral resection of bladder tumor in the management of bladder tumor during pregnancy.</p><p><strong>Material and methods: </strong>This is a retrospective study over a period of 6 years carried out at a tertiary referral center. Pregnancy patients with bladder tumors underwent transurethral bipolar resection of tumor and any complication or adverse event during the procedure were recorded. Disease and obstetric outcome was analyzed to access the safety and effectiveness of this procedure during pregnancy.</p><p><strong>Results: </strong>Seven pregnant patients were with an average age of 38.5 ± 4.2 years and average gestational age of 21.5 ± 7.5 weeks underwent bipolar TURBT in last 6 years. Smoking as a risk factor was identified in one patient, and one patient had personal history of bladder tumor. Majority of patients presented with gross hematuria (57.14%). The mean resection time was 19.5 ± 8.9 min, and the average hospital stay was 2.5 ± 0.5 days. There was no major complication recorded in intraoperative or postoperative period.</p><p><strong>Conclusion: </strong>Bipolar TURBT is safe and effective in the management of bladder tumor during pregnancy.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 5","pages":"405-409"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micronutrients in Obstetrics and Gynecology: Mini-Review Article.","authors":"Alka Pandey","doi":"10.1007/s13224-025-02244-z","DOIUrl":"10.1007/s13224-025-02244-z","url":null,"abstract":"<p><p>Micronutrients are fundamental in maintaining the general health of a woman and play a pivotal role in reproductive health, with heightened importance during pregnancy and lactation. Deficiencies in vitamins and minerals-common globally-are associated with adverse maternal and fetal outcomes such as anemia, preeclampsia, gestational diabetes, neural tube defects (NTDs), and intrauterine growth restriction. Micronutrients may affect the programming of fetal origin of adult diseases. Micronutrient deficiency also plays a part in gynecological disorders such as polycystic ovary syndrome, infertility, endometriosis, fibroids and certain gynecological malignancies. A systematic review of 31 recent articles, including cohort studies and meta-analyses, was conducted through databases such as PubMed, Google Scholar and ScienceDirect. Twenty-five articles were selected based on relevance and methodological rigor. Deficiencies in iron, folate, vitamin D, zinc, iodine, and vitamin B12 are prevalent among pregnant women, particularly in India. Iron supplementation reduces anemia, but its broader impact remains inconclusive. Folic acid prevents up to 70% of NTDs when started preconceptionally. Calcium and vitamin D lower the risk of preeclampsia. Zinc and iodine deficiencies contribute to poor pregnancy outcomes. Multiple micronutrient supplementation (MMS) has shown superior efficacy compared to iron-folic acid alone in reducing low birth weight and small-for-gestational-age outcomes, though optimal formulations require further study. Adequate micronutrient intake is essential for optimal maternal and fetal health. MMS offers a promising intervention but should be tailored to individual needs to prevent over-supplementation. Future research must address micronutrient interactions, population-specific needs, and personalized nutrition strategies.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 5","pages":"371-376"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the Acceptance Rate of Long Acting Reversible Contraception as a Method of Post-abortion Contraception: A Prospective Quality Improvement Study.","authors":"Ashish Kale, Avir Sarkar, Ashwini Kale, Prathamesh Lanjewar, Aruna Kumari Yerra, Neelam Verma, Sneha Kumari","doi":"10.1007/s13224-025-02135-3","DOIUrl":"10.1007/s13224-025-02135-3","url":null,"abstract":"<p><strong>Background: </strong>Among the 121 million unintended pregnancies annually of which 61% (73.3 millions) ended up in abortion. This huge 61% figure reminds us of the unmet need for family planning which still remains a global health issue. So, comes the utmost need for post-abortion contraception (PAC) which significantly minimizes the risk of repeat unintended pregnancies. Long acting reversible contraception (LARC), requiring administration less than once a month, remains the most recommended contraceptive method by international bodies like the center for disease control and the American College of Obstetricians and Gynecologists. Still it remains underutilized despite its contraceptive and non-contraceptive benefits. This QI project aimed to address the barriers to acceptance of LARC as a PAC in the Indian scenario, thereby introducing appropriate interventions to improve the existing acceptance rate of LARC by at least 50% by baseline.</p><p><strong>Materials and methods: </strong>This QI was conducted at a tertiary care teaching hospital over a period of 24 months (July 2021 to June 2023) using a point-of-care QI methodology systematically. This QI study was conducted in three phases: a pre-intervention baseline phase (6 months), an intervention phase with three PDSA cycles (12 months: each PDSA cycle of 4 months) and a post-intervention follow-up phase (6 months). The QI study has been done in strict compliance with the SQUIRE guidelines.</p><p><strong>Results: </strong>Baseline observations showed poor acceptance of LARC as PAC with the average of 14.5% over a period of six months. After the end of first cycle, LARC acceptance rate improved to 40%. At the end of the second PDSA cycle, the rate of acceptance increased to 52.6%. Highest level of acceptance was observed after the third cycle which was about 75%. Although a minimal decrease in the acceptance of LARC was noted in subsequent months (ranging from 57.8 to 69.2%; average 62.9%), a satisfactory increase in the acceptance of LARC as PAC was observed when compared to the baseline data (acceptance of 14.5%).</p><p><strong>Conclusion: </strong>Improvement in the acceptance of LARC as PAC was the result of proper communication and effective counselling. It was through the collaborative effort of the entire team and meticulous counselling by doctors, nursing staff and counselors that a good acceptance rate could be sustained over time.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 5","pages":"377-384"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Struma Salpingis with Tubal Ectopic Pregnancy.","authors":"Sunayna Lashkari, Bharti Singh, Shreya Kampoowale, Deepti Soni, Ashwani Tandon, Sushmita Maurya","doi":"10.1007/s13224-025-02119-3","DOIUrl":"10.1007/s13224-025-02119-3","url":null,"abstract":"","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 5","pages":"451-452"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antenatal Management and Pregnancy Outcomes in Patient with factor X Deficiency Managed with Prothrombin Complex Concentrates.","authors":"Sarada Mamilla, Navaneetha Elati, Parul Shukla","doi":"10.1007/s13224-025-02129-1","DOIUrl":"10.1007/s13224-025-02129-1","url":null,"abstract":"","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 5","pages":"442-444"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Risk Profile of Eastern Indian Women with Different Phenotypes of Polycystic Ovary Syndrome.","authors":"Suparna Biswas, Kasturi Mukherjee, Raghunath Bhattacharyya, Ananya Mukherjee, Subhash Chandra Biswas, Satinath Mukhopadhyay","doi":"10.1007/s13224-025-02188-4","DOIUrl":"10.1007/s13224-025-02188-4","url":null,"abstract":"<p><strong>Objective: </strong>To determine different clinical, hormonal and biochemical parameters among all four phenotypes of women with PCOS in Eastern India that may help in identifying and intervening the at risk group of women going to develop metabolic syndrome.</p><p><strong>Methods: </strong>This is a cross-sectional study involving women from Eastern India, suffering from PCOS attending Gynaecological OPD at IPGMER, Kolkata. Consecutive 126 PCOS women recruited, diagnosed using revised Rotterdam criteria 2003, were categorized into four different PCOS phenotypes. Demographic, clinical, biochemical, endocrine and metabolic parameters were analyzed, using SPSS 11.0.</p><p><strong>Results: </strong>The differences in the levels of Fasting Insulin, glycosylated hemoglobin (Hb A1C), Triglyceride, Cholesterol, high density lipoprotein cholesterol, Total Testosterone, Anti-Müllerian hormone and insulin resistance were statistically significant across the four groups. The prevalence of obesity, abnormal of lipid profile, insulin resistance were highest in phenotype B. Prevalence of metabolic syndrome was much higher in phenotypes A and B (19.51% and 20.0%) compared with phenotype C and D (7.69% and 7.41%).</p><p><strong>Conclusion: </strong>It's important to recognize PCOS phenotypes, correct the hormonal and metabolic disorder in time to rescue them before PCOS becomes a full blown metabolic syndrome.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 5","pages":"392-399"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment and Establishment of Determinants of Sexual Activity in Pregnancy in Primigravidae and Multigravidae.","authors":"Apurva A Gandhi, Padmaja Y Samant","doi":"10.1007/s13224-025-02165-x","DOIUrl":"10.1007/s13224-025-02165-x","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy is a special period in a woman's life that involves physical and mental changes. This study aimed at evaluating woman's sexual experience in pregnancy.</p><p><strong>Methods: </strong>Cross sectional study design. We collected data pertaining to pregnant women's sexual behaviour via a questionnaire from 171 healthy pregnant women. Responses were summarised and comparisons were made between trimesters of pregnancy and primigravidae and multigravidae.</p><p><strong>Results: </strong>We studied various aspects such as marriage related information, factors affecting sexual activity, frequency of sexual activity across trimesters, causes for abstinence of sexual activity in primigravidae and multigravidae. The majority of women perceived an overall decline in sexual desire progressively increasing in each trimester. None of the patients reported an increase in coital frequency. We determined that in 62 cases, the source of information regarding sexual activity during pregnancy was their partners.</p><p><strong>Conclusion: </strong>The authors encourage the provision of sexuality education to newlyweds and the resolution of sex-related concerns during pregnancy.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 5","pages":"410-414"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Problems with Classifying Type 3 Uterine Fibroids as Submucous in the 2018 FIGO Revisions.","authors":"Atef Darwish, Dina Darwish","doi":"10.1007/s13224-025-02105-9","DOIUrl":"10.1007/s13224-025-02105-9","url":null,"abstract":"<p><strong>Background: </strong>FIGO classification of a 100% intramural fibroid contacting the endometrium as type 3.</p><p><strong>Objectives: </strong>Pros and cons of this modification are discussed.</p><p><strong>Conclusion: </strong>Hysteroscopic myomectomy of type 3 fibroid is a risky procedure and should be cautiously performed by an expert hysteroscopist. More research is required to assess safety issues and feasibility of either hysteroscopic or laparoscopic myomectomy in type 3 fibroids.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 5","pages":"449-450"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triptorelin 0.1 mg as a Luteal Phase Support in Antagonist Intracytoplasmic Sperm Injection Cycles.","authors":"Kamal M Zahran, Moustafa M A Ahmed, Tarek A Farghaly, Azza A Elsayed, Ihab M El-Nashar","doi":"10.1007/s13224-025-02121-9","DOIUrl":"10.1007/s13224-025-02121-9","url":null,"abstract":"<p><strong>Background: </strong>Transvaginal progesterone is used to aid throughout the luteal phase. Administering a dose of gonadotrophin-releasing-hormone analogues (GnRHa) six days following OPU in GnRH antagonist cycles might cause rise in pituitary gonadotropins (luteinizing hormone (LH) and follicle-stimulating hormone (FSH)), leading to rise in steroid synthesis (estradiol (E2) and progesterone (P)) by the corpora lutea (CL). This work aimed to contrast the effect of lipopolysaccharides (LPS) with adding GnRHa to progesterone P, at day six after ovum pickup versus P alone, on the clinical pregnancy rate.</p><p><strong>Methods: </strong>This open labeled randomized controlled trial study was carried out at women health hospital (WHH), Assiut University on 150 women with antagonist controlled ovarian hyperstimulation protocol (COH). Individuals had been categorized into two groups: Study group: include women who obtained 0.1 mg of GnRH agonist \"triptorelin\" at day 6 after OPU in addition to (P) since day of oocyte pickup (OPU) compared with the control group: administration of P only since (OPU) as LP support.</p><p><strong>Results: </strong>Women who received GnRHa 0.1 mg & P as LPS were reported significant higher progesterone level, beta human chorionic gonadotropins (BHCG) level, fetal pulsation, implantation rate, clinical pregnancy rate, biochemical pregnancy rate, ongoing pregnancy and live birth rates contrasted to control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Adding GnRHa to P as LPS is associated with significant higher progesterone level at day 7 after OPU BHCG day 14 of embryo transfer, clinical pregnancy rate, biochemical pregnancy rate, implantation rate, ongoing pregnancy rate, and live birth rate.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 4","pages":"290-296"},"PeriodicalIF":0.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}