{"title":"Targeting Global Coverage: Comparison of In-Hospital OGTT at 2-3 Days Postpartum with OGTT at 6-12 Weeks Postpartum for Predicting Glucose Intolerance in Postpartum Women with Gestational Diabetes Mellitus.","authors":"Pikee Saxena, Simran Kaur Arora, Anupam Prakash, Rajeev Chawla, Anjalakshi Chandrasekar, Hema Diwakar, Rajesh Jain, Veeraswamy Seshiah","doi":"10.1007/s13224-025-02123-7","DOIUrl":"10.1007/s13224-025-02123-7","url":null,"abstract":"<p><strong>Background: </strong>Recognizing the importance of postpartum testing for dysglycaemia after gestational diabetes mellitus (GDM), follow-up visit is recommended by all guidelines; unfortunately, dropout rate for follow-up is very high.</p><p><strong>Objective: </strong>Comparison of diagnostic accuracy of early OGTT on day 2 or 3 postpartum with late OGTT at 6-12 weeks for predicting dysglycaemia in women with GDM in index pregnancy.</p><p><strong>Methods: </strong>A total of 250 women with GDM underwent early WHO OGTT testing at 2-3 days postpartum, repeated at 6-12 weeks postpartum. Diagnostic accuracy, sensitivity, specificity, AUC, NPV, and PPV of early OGTT were calculated with 6-12 weeks OGTT as the gold standard.</p><p><strong>Results: </strong>Of the 250 women, 100% completed glucose testing at 2-3 days postpartum while 86% returned at 6-12 weeks for repeat testing despite repetitive phone calls. At 2-3 days of testing, 26.80% women had impaired fasting glucose (IFT), 26.40% women had impaired glucose tolerance (IGT), and 3.20% women had DM. At 6-12 weeks testing, 25% had IFT, 29.81% had IGT. Early OGTT had a sensitivity of 86.15%, specificity of 91.61%, AUC of 0.89, NPV of 93.57%, PPV of 82.35% for predicting dysglycaemia. 51.6% were found to be suffering from metabolic syndrome during 2nd postpartum visit.</p><p><strong>Conclusion: </strong>Early OGTT has the advantage of 100% coverage of women with GDM and may have comparable accuracy to conventional OGTT at 6-12 weeks postpartum in detecting impaired glucose status. Counselling and appropriate intervention before discharge may support prevention or delay the progression of diabetes and associated metabolic disorders.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 3","pages":"253-257"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531062","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}
Okechukwu S Ogah, Olanike A Orimolade, Akinyemi Aje, Oluwabunmi C Adeyeye, Abdulhammed O Babatunde, Fisayo Ogah, Oreoluwa J Alabi, Chioma F Obiorah, Chukwuebuka S Asogwa, Temitope Ilori, Gbolahan Obajimi, Abiodun M Adeoye, Olulola O Oladapo, Adewole A Adebiyi
{"title":"Clinical Profile and Intra-Hospital Outcomes of Peripartum Cardiomyopathy in Ibadan, Nigeria.","authors":"Okechukwu S Ogah, Olanike A Orimolade, Akinyemi Aje, Oluwabunmi C Adeyeye, Abdulhammed O Babatunde, Fisayo Ogah, Oreoluwa J Alabi, Chioma F Obiorah, Chukwuebuka S Asogwa, Temitope Ilori, Gbolahan Obajimi, Abiodun M Adeoye, Olulola O Oladapo, Adewole A Adebiyi","doi":"10.1007/s13224-025-02116-6","DOIUrl":"10.1007/s13224-025-02116-6","url":null,"abstract":"<p><strong>Aim: </strong>The clinical profile of the disease in southern Nigeria is less reported. This study aims to describe the clinical characteristics and intra-hospital outcomes of PPCM in Ibadan, south-west Nigeria.</p><p><strong>Materials and methods: </strong>We reviewed 69 cases of PPCM seen in Nigerian Women at the University College Hospital Ibadan between 2006 and 2021.</p><p><strong>Results: </strong>The mean age at presentation was 30.5 ± 6.7 years (age range 18 - 46 years). The mean BMI was 23.5 kg/M<sup>2</sup>. Most were from the low socio-economic group (47/68.1%) and presented postpartum. The majority were primipara; twin pregnancy was seen in four (5.8%), and PIH occurred in 10 (14.5%) cases. Heart failure was the most typical mode of presentation. Over 90% of the women had spontaneous vertex delivery. Fetal death was recorded in three (4.3%). Two women died. Both presented with severe heart failure and died within few days on admission.</p><p><strong>Conclusion: </strong>PPCM in Ibadan, Nigeria, is relatively a disease of primipara from poor homes and in unbooked pregnant women. Improvement in maternal health will be invaluable in prevention of the condition in Nigeria.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 3","pages":"238-245"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530964","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}
Jyotsna S Dwivedi, Dhruvi R Shah, Gaurav S Desai, Kimaya A Mali, Niranjan M Mayadeo
{"title":"Maternal and Foetal Outcomes of Leptospirosis in Pregnancy: An Observational Descriptive Study at a Tertiary Care Centre in Western India.","authors":"Jyotsna S Dwivedi, Dhruvi R Shah, Gaurav S Desai, Kimaya A Mali, Niranjan M Mayadeo","doi":"10.1007/s13224-024-02080-7","DOIUrl":"10.1007/s13224-024-02080-7","url":null,"abstract":"<p><strong>Background: </strong>Leptospirosis is one of the most prevalent zoonoses worldwide. Its presentation is varied in severity and non-specific mimicking other infectious diseases and pregnancy conditions such as HELLP or AFLP.</p><p><strong>Aims and objectives: </strong>This study aims to evaluate the maternal and foetal outcomes of leptospirosis and estimate its prevalence in pregnancy at a tertiary care centre.</p><p><strong>Methods: </strong>This is an observational descriptive study conducted at a tertiary care teaching hospital in Western India over a duration of 5 years. All pregnant patients diagnosed as leptospirosis via IgM ELISA were included.</p><p><strong>Results: </strong>A total of 37 patients were enrolled. Majority presented in the first trimester and belonged to the low socio-economic strata. Fever was the most persistent symptom. Five patients had a spontaneous abortion, two underwent MTP, eight had a preterm delivery, whereas 22 patients carried up till term (of which 18 delivered vaginally and four underwent a LSCS). Majority had leucocytosis and were anaemic. Twelve cases had hyperbilirubinaemia, six had deranged transaminases, three had raised serum creatinine values and two had thrombocytopenia. Four patients required management in the ICU out of which two progressed to Weil's disease and one succumbed to death. The research team at our centre yielded an estimated 9.06% prevalence of leptospirosis.</p><p><strong>Conclusion: </strong>Leptospirosis is often underdiagnosed and hence under-reported. Being a re-emerging infectious disease, an early clinical suspicion and sound understanding of the disease process in pregnant women is required.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 3","pages":"213-219"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531054","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":"Rise and Rise of Endometriosis-An Enigma.","authors":"Sujata Dalvi","doi":"10.1007/s13224-025-02176-8","DOIUrl":"10.1007/s13224-025-02176-8","url":null,"abstract":"<p><p>Endometriosis is considered 'silent disease' but is debilitating that impacts quality of life. It is chronic, benign condition which is oestrogen dependent and has chronic inflammatory component. Endometriosis is associated with menstruation with increased sensitivity to oestrogen receptors and with low progesterone levels. Locally produced prostaglandins from endometriotic lesions leads to pain. There is delay in diagnosis by several years, as symptoms are not specific. This can lead to decline in fertility and quality of life. Imaging techniques and bio markers are not very specific but definitive diagnosis can be with Laparoscopy and histopathology. The first line of therapy will be medical, for relief of pain and fertility. Surgery is advised after failure of medical therapy, for severe degree of disease and deep infiltrating endometriosis (DIE). Assisted reproductive technology (ART) therapy is proposed for improved fertility outcome after surgery. Recurrence is known to occur after therapy.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 3","pages":"185-191"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531060","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}
Arun Kishore N Ravivarman, Smitha Santhosh, Reena Ravindran, K S Shaji
{"title":"Managing Professional Stress is Every Doctor's Business.","authors":"Arun Kishore N Ravivarman, Smitha Santhosh, Reena Ravindran, K S Shaji","doi":"10.1007/s13224-024-02025-0","DOIUrl":"10.1007/s13224-024-02025-0","url":null,"abstract":"","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 3","pages":"273-274"},"PeriodicalIF":0.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531053","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}
Ritam Kumari, Alpana Singh, B D Banerjee, Chander Grover, Kiran Guleria
{"title":"Impact of Metformin Therapy on Chronic Inflammatory Markers Serum Fractalkine and CRP Levels in Polycystic Ovary Syndrome: A Pilot Study on Chronic Inflammatory Markers and Clinical Outcomes.","authors":"Ritam Kumari, Alpana Singh, B D Banerjee, Chander Grover, Kiran Guleria","doi":"10.1007/s13224-025-02100-0","DOIUrl":"10.1007/s13224-025-02100-0","url":null,"abstract":"<p><strong>Introduction: </strong>Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, with a prevalence of 8-13% depending on diagnostic criteria. Its pathophysiology is linked to insulin resistance and resulting chronic inflammation. This study compares serum levels of fractalkine and high-sensitivity C-reactive protein (hs-CRP), markers of chronic inflammation, in PCOS patients before and after metformin therapy.</p><p><strong>Materials and methods: </strong>Thirty women with PCOS were recruited from gynecology and dermatology OPDs. Their serum fractalkine and hs-CRP levels were measured before starting metformin. The patients were then administered metformin, beginning with 500 mg once daily and increasing to 500 mg three times daily over four months, followed by repeat measurements of serum fractalkine and hs-CRP.</p><p><strong>Results: </strong>Post-metformin therapy, a significant reduction in serum fractalkine levels was observed (from 0.52 ± 0.29 to 0.38 ± 0.21 ng/ml, <i>p</i> = 0.001). Similarly, hs-CRP levels decreased significantly (from 0.71 ± 0.37 to 0.58 ± 0.27 ng/ml, <i>p</i> = 0.016). Clinical improvements in hirsutism, acne, acanthosis, and BMI were also noted, alongside a significant reduction in insulin resistance parameters.</p><p><strong>Conclusion: </strong>Chronic inflammation in PCOS contributes to insulin resistance. Metformin therapy, by improving insulin resistance, reduces hyperinsulinemia and hyperglycemia, leading to decreased production of reactive oxygen species and amelioration of chronic inflammation. This is evidenced by lowered serum fractalkine and hs-CRP levels and improved insulin resistance parameters in this study.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 2","pages":"115-121"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995223","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":"Analyzing Maternal Mortality During COVID-19 Pandemic.","authors":"Harish Gupta","doi":"10.1007/s13224-024-02021-4","DOIUrl":"10.1007/s13224-024-02021-4","url":null,"abstract":"","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 2","pages":"182-183"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052891","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":"Get the Artificial Intelligence (AI) Edge in Obstetrics and Gynaecology.","authors":"Sujata Dalvi","doi":"10.1007/s13224-025-02127-3","DOIUrl":"10.1007/s13224-025-02127-3","url":null,"abstract":"<p><p>Artificial intelligence (AI) is on the fast track so far as the growth is concerned, from experimental to implementation in field of medicine. AI should be used ethically and intelligently. Large data base availability, advances in algorithm-theories, computing improvements has led to breakthrough in AI applications in current medicine. Machine learning (ML), which is subset of AI, allows computers to detect patterns through larger data base automatically, that can be used to make predictions. Is it paradigm shift? In the field of Obstetrics and Gynaecology, AI is used in reproductive medicine for diagnosis, treatment with fertility outcome, cancer treatment, USG-MRI images diagnosis, foetal echocardiography, cardiotocography (CTG), preterm labour prediction and urogynaecology. ChatGPT can be helpful in medical writing but there is always a challenge with respect to accuracy and reliability. AI can be used in research and experiments, there by strengthening evidence-based clinical practice. More research is ongoing on personalized diagnosis, treatment and remote medical expert team opinion. It does not replace the medical advice given by the clinician but that should not deter clinician by exploring more uses of AI. Despite various challenges and limitations, integration of AI in medical field is bound to progress in correct direction for better future.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 2","pages":"95-100"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055688","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":"Untimely Menopause, State Wise Prevalence and Determinants: Insights from Longitudinal Aging Study in India (LASI-1).","authors":"Pritam Halder, Subham Kansal, Anshul Mamgai, Shivani Rathor, Anamika Das, Gaurav Garg","doi":"10.1007/s13224-024-02094-1","DOIUrl":"10.1007/s13224-024-02094-1","url":null,"abstract":"<p><strong>Background: </strong>Untimely menopause refers to occurrence of menopause before the age of 40 years or after 55 years, termed as pre-mature or delayed menopause. This is a secondary data analysis of LASI-1 to estimate prevalence of untimely menopause and its determinants.</p><p><strong>Materials and methods: </strong>LASI-1, a longitudinal study collected detailed information on the psychological, social, economic and health aspects of ageing in India. Baseline data was collected from year 2017-2019 in all 35 states and union territories in India. 73,396 adults were interviewed aged 45 years and above. In this study, we analysed prevalence of untimely menopause and its determinants from the data using bivariate and logistic regression analysis.</p><p><strong>Results: </strong>In this study, 25,256 women's data was analysed to estimate the prevalence. 7.4%, 17.5% and 13.4% women had pre-mature (menopause less than 40 years), early (between 40 and 44 years) and delayed menopause (after 55 years), more so in a few southern states of the country. Determinants for untimely menopause were area of residence (higher in rural area), education status (greater in higher educational status), working status (more in currently working women), and consumption of alcohol.</p><p><strong>Conclusion: </strong>There is high prevalence of untimely menopause and more so in a few southern states of the country, which is a cause of concern and needs specific attention.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 2","pages":"106-114"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055118","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}
Archana Mishra, Chhavi Gupta, Saritha Shamsunder, Sachin Kolte, Shaivy Malik
{"title":"Vulval Myxoma in a Young Female: An Extremely Rare Occurrence.","authors":"Archana Mishra, Chhavi Gupta, Saritha Shamsunder, Sachin Kolte, Shaivy Malik","doi":"10.1007/s13224-024-02011-6","DOIUrl":"10.1007/s13224-024-02011-6","url":null,"abstract":"","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"556-559"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102906","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}