Journal of Obstetrics and Gynecology of India最新文献

{"title":"Charged Up and Marching Ahead….","authors":"Sujata Dalvi","doi":"10.1007/s13224-025-02103-x","DOIUrl":"https://doi.org/10.1007/s13224-025-02103-x","url":null,"abstract":"","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 1","pages":"1-2"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651844","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":"President's Address.","authors":"Sunita Tandulwadkar","doi":"10.1007/s13224-025-02098-5","DOIUrl":"https://doi.org/10.1007/s13224-025-02098-5","url":null,"abstract":"","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 1","pages":"3-11"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651931","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":"Age of Viability: Clarifying Prenatal Documentation and Definitions in India's Contemporary Medical Landscape.","authors":"Girija Wagh","doi":"10.1007/s13224-024-02096-z","DOIUrl":"10.1007/s13224-024-02096-z","url":null,"abstract":"<p><p>The concept of foetal viability has evolved significantly and has been influenced by advancements in neonatal care and legal frameworks. This review explores the complexities of defining foetal viability in India's contemporary medical landscape, particularly in light of the recent extension of the Medical Termination of Pregnancy (MTP) Act to 24 weeks. The article examines the confusion surrounding the classification of extreme preterm births, Medical Termination of Pregnancy (MTP) Act, and prenatal documentation during sonography. It addresses the challenges in distinguishing between preterm birth and abortion and proposes solutions to standardize definitions and practices.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 6","pages":"484-488"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933551","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":"Recent Trends in Medical Management of Endometriosis.","authors":"Madhuri Patel","doi":"10.1007/s13224-024-02097-y","DOIUrl":"10.1007/s13224-024-02097-y","url":null,"abstract":"<p><p>Endometriosis affects about 10 percent women in the reproductive age group globally and approximately 42 million in India. Managing the patient's pain symptoms associated with endometriosis appears to be the cornerstone in endometriosis disease management. The ideal medical treatment in endometriosis would be suppressing estradiol enough to alleviate symptoms of endometriosis but maintain sufficient levels to mitigate hypoestrogenic side effects. NSAIDs are generally prescribed for the initial management of pain symptoms in endometriosis along with hormonal agents like progestogens or combined oral contraceptive pills (COCPs). Injectable depot gonadotropin-releasing hormone (GnRH) agonists such as leuprolide acetate and letrozole are effective as second-line agents in the management of endometriosis-associated pain. Dienogest is a 19-nortestosterone derivative which has a high specificity for progesterone receptors and improves endometriosis-related symptoms and the overall quality of life. Dydrogesterone is quite effective in the treatment of endometriosis-associated pelvic pain without causing suppression of ovulation. GnRH agonists and GnRH antagonists both have been used in the treatment of endometriosis. Elagolix a first oral, non-peptide gonadotropin-releasing antagonist for the management of moderate to severe pain associated with endometriosis is successfully used. Aromatase inhibitors are used as second-line drugs in the management of endometriosis-associated pelvic pain. They prevent the conversion of steroid precursors to estrogens, both at the periphery and at the ovarian level. Tamoxifen, raloxifene and bacidoxifen have an anti-proliferative effect and regress the endometriotic implants. Mifepristone (progesterone receptor antagonist) and Ulipristal acetate (SPRM) have been used for medical management of endometriosis. LNG-IUS is emerging as a good option for patients with endometriosis who are not desirous of conception. Hormonal management is one of the effective management options in endometriosis. One has to be mindful of molecule-specific adverse effects while prescribing drugs.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 6","pages":"479-483"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933474","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":"Call For Action: The Obstetrician's Role In Peripartum Mental Health.","authors":"Anahita R Chauhan, Arnav R Chauhan","doi":"10.1007/s13224-024-02076-3","DOIUrl":"10.1007/s13224-024-02076-3","url":null,"abstract":"<p><p>Peripartum mental health is an underdiagnosed and undertreated entity; obstetricians are in a dilemma when patients present with signs of any mental disturbance. The peripartum period is fraught with triggers that can cause, or exacerbate, mental illness, and obstetricians need to be aware of diagnoses and treatment of blues, depression, psychosis and other problems. Key strategies that can be adopted are discussed in this review, along with the scenario in India.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 5","pages":"386-390"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683291","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":"Predictive Role of HE4 in Diagnosis of Ovarian Tumors.","authors":"Satya Kumari, Pratibha Kumari, Sangeeta Pankaj, Jyotsna Rani, Kavya Abhilashi, Vijayanand Choudhary, Jaya Kumari","doi":"10.1007/s13224-023-01936-8","DOIUrl":"10.1007/s13224-023-01936-8","url":null,"abstract":"<p><strong>Background: </strong>Approximately 20% of women develop an ovarian cyst or pelvic mass at some point in their lives. Due to high false positivity of CA-125, women with various benign ovarian tumors simulating malignant masses undergo extensive debulking surgery resulting in increased morbidity. Serum HE4 is a useful test for better discrimination of benign or malignant nature of pelvic masses in preoperative period. Our study gives an update on the biological markers specifically CA-125 and a novel tumor marker HE4 and aims to reduce the debulking surgeries done for benign pathology.</p><p><strong>Materials and methods: </strong>The total study population (<i>n</i> = 302) included women who were operated with suspicious ovarian malignant mass (<i>n</i> = 238) with benign (<i>n</i> = 98), borderline (<i>n</i> = 6), and malignant (<i>n</i> = 134) ovarian tumors. Cutoff of CA-125 was 35 U/mL, and for HE4 140 pM for postmenopausal and 70 pM for premenopausal women were calculated at 86% and 81% accuracy, respectively. Statistical analysis was done using SPSS version 20.</p><p><strong>Results: </strong>The cutoff values of CA-125 were able to differentiate between benign, borderline, and malignant tumors with statistical significance (<i>p</i> < 0.05), whereas the cutoff values of HE4 significantly (<i>p</i> < 0.05) differentiated benign tumors from the malignant tumors, but not from the borderline tumors. Serum CA-125 has significantly higher sensitivity and NPV (95%, 72%, respectively) compared to HE4 (81%, 52%) and combined HE4 plus CA-125 (84%, 59%), whereas specificity, PPV, and AUC were higher for combined CA-125 plus HE4 (93%, 98%, 90%, respectively) compared to HE4 (83%, 95%, 88%) and CA-125 (48%, 88%, 87%).</p><p><strong>Conclusion: </strong>Measuring serum HE4 along with CA-125 in preoperative diagnosis helps in excluding benign ovarian tumors in which CA-125 was falsely raised, especially in center where frozen section is not available, thus potentially decreasing morbid debulking surgeries done for benign ovarian tumors.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 5","pages":"418-423"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683309","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":"\"To Give or Not to Give\": Evolution of Recommendations on Administering Antenatal Corticosteroids in Late Preterm or Early Term.","authors":"Deepshikha, Japleen Kaur, Sahil Vikas","doi":"10.1007/s13224-024-01996-4","DOIUrl":"10.1007/s13224-024-01996-4","url":null,"abstract":"","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 5","pages":"472-473"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683184","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":"The Conundrum of Preterm Labour and Premature Births in Present Day Obstetrics.","authors":"Madhuri Patel","doi":"10.1007/s13224-024-02070-9","DOIUrl":"10.1007/s13224-024-02070-9","url":null,"abstract":"<p><p>Preterm Labour leading to premature births has remained one of the longest unresolved conundrums in medicine. This \"conundrum\" of issues surrounding preterm labour and birth appears to be complex. While we continue to accept that preterm birth is difficult to predict, we are being faced with an increasing trend in preterm births owing to the preponderance of the known risk factors in the present day Obstetric population. Health care providers should know that the challenges in handling preterm births and the role of Obstetricians in improving the overall health scenario in this context has to extend beyond mere individual patient care. Adequate sensitisation of both the perinatal care team, smooth referral pathways and providing realistic choices to the family are all important in reaching a rational outcome. Optimising perinatal care for preterm babies will go a long way in achieving the sustainable development goal of ending preventable neonatal deaths.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 5","pages":"383-385"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683321","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":"\"Modernizing Cervical Cytology Screening with Liquid-Based Methods at Community-Level Hospitals: A Much-Needed Breakthrough for India\".","authors":"Sunil E Tambvekar, Geetha Balsarkar","doi":"10.1007/s13224-024-02051-y","DOIUrl":"10.1007/s13224-024-02051-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Cervical cancer still ranks highest causing cancer-related morbidity and mortality in women in India. It is prudent to emphasise and implement cervical cancer screening strategies in the population efficiently and with regular intervals. Conventionally, PAP smear cytology is obtained by wooden spatula-Ayre's spatula. To improve sensitivity and specificity of the procedure and detection rate, better techniques of cells retrieval are available mainly liquid-based cytology (LBC), with help of cyto-brush. Literature has consistently proven efficiency of the technique and also reduced the proportion of inadequate sampling. We conduct this study to compare both the techniques and efficiency in a community hospital from data over 6 years, to asses its role and benefits among Indian women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims and objectives: &lt;/strong&gt;To compare conventional PAP smear and liquid-based cytology techniques analysing detection rates of positive lesions (CIN and also includes ASCUS and malignant), incidence of inadequate sampling, efficiency and cost-effectiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is retrospective study at tertiary care obstetric hospital affiliated to government-run medical college in a metropolitan city of Mumbai. Data are retrieved from the Pathology Department, Medical Records Department, laboratory books and OPD registers. Pap's smear sampling was done mainly from OPD with all indications including routine tests as a part of gynaecological evaluation and screening, as well as for suspicious lesions on inspection. Group A consists women who had conventional PAP smear test for 3 years (Dec 2015-Nov 2018) and Group B had women who benefited by LBC method for 3 years (Dec 2018-Nov 2021). COVID-19 pandemic majorly affected the routine gynaecological OPD practice during 2021 as hospital was COVID facility hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Demographic parameters and presentations were comparable and similar. LBC methods have higher detection rate for positive reports, including ASCUS. But results were comparable in both groups and not statistically different. Importantly, incidences of inadequate sampling are reduced significantly with the LBC method. Unsatisfactory smears war high in Group A (7.752%) compared to Group B (3.712%) &lt;i&gt;p&lt;/i&gt;-value 0.005, stating the increased rate of requirement of sending repeat smears, which involves higher engagement of time, resources and active participation from healthcare personnel.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Good detection rates and significantly low rates of unsatisfactory smears make LBC rational and cost-effective. These are the times to switch to liquid-based cytology techniques, especially at the community level hospitals; in order to detect more women with cervical premalignant as well as malignant neoplastic lesions and to save lives. This can be made possible by emphasising the policy makers to incorporate these services through quality resource","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 4","pages":"371-377"},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300512","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":"Staging of Cervical Cancer: What has Changed?","authors":"Pradnya Changede","doi":"10.1007/s13224-024-02054-9","DOIUrl":"10.1007/s13224-024-02054-9","url":null,"abstract":"<p><p>In India, cervical cancer is the second most common cause of cancer-related fatalities and the fourth most common malignancy worldwide affecting women. India accounts for 25% of all cervical cancer-related deaths worldwide each year. The main drawbacks of clinical staging were the imprecise estimation of tumor size and the challenge of determining the involvement of pelvic and para-aortic lymph nodes with the few studies that FIGO allowed to be done for staging of cancer cervix. The use of 2009 staging approach showed that when many cases were operated based only on clinical findings, they subsequently required adjuvant therapy; hence, treatment-related morbidity was negatively impacted by these errors. Changes have been made to the staging of cervical cancer according to the 2018 revised International Federation of Gynecology and Obstetrics (FIGO) guidelines. Correction to cancer of the cervix staging was published recently in 2024. The horizontal extent (lateral extent) of the disease is not taken into consideration for staging in cases of microinvasive disease. Three subgroups have been identified based on the stratification of tumor size: IB1 ≤ 2 cm, IB2 > 2- ≤ 4 cm, and IB3 > 4 cm. Pathology and imaging modalities are added to clinical diagnosis for staging of cancer cervix. The involvement of lymph nodes (LNs) is now classified based on pathology (p) or imaging (r) which specifies that lymph node involvement is diagnosed using pathology (p) or imaging (r). Stage IIIC has been added [IIIC1 (involvement of pelvic nodes) and IIIC2 (involvement of para-aortic nodes)] is assigned to the case in the event of lymph node positive status. Pathological assessment takes precedence over radiological and clinical findings. The involvement of vascular/lymphatic spaces should not change the staging. The lower staging should be assigned when there is doubt about stage. Overall, the revised FIGO staging of cancer cervix (2024) has a number of advantages, including the inclusion of imaging and pathology, tumor size and LN-based categorization. More studies on staging of cancer cervix in different populations using revised staging of cancer cervix will help to prognosticate use of this staging.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"74 4","pages":"378-381"},"PeriodicalIF":0.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300518","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}