Journal of Obstetrics and Gynecology of India最新文献

{"title":"Impact of Glycemic Variability on Vaginal Flora Alterations and Concomitant Antimicrobial Resistance During Pregnancy: Implications for Fetomaternal Outcomes.","authors":"Dalia Rafat, Anubha Agrawal, Sunita Singh, Shamsi Khalid, Asad U Khan, Tabassum Nawab","doi":"10.1007/s13224-024-02095-0","DOIUrl":"10.1007/s13224-024-02095-0","url":null,"abstract":"<p><strong>Purpose: </strong>Vaginal flora alterations (AVF) have been implicated in both health and disease states. Few studies have looked at the connection between AVF and adverse fetomaternal outcomes(AFMOs), and even fewer have assessed their concurrent link with gestational diabetes mellitus (GDM). Therefore, this study investigated the association between AVF and GDM and their impact on AFMOs. In addition, we assessed the antimicrobial resistance(AMR) of isolated pathogens and sought to identify the associated risk factors.</p><p><strong>Methods: </strong>This prospective, cross-sectional study was conducted among 640 pregnant women; divided into two groups, GDM and non-GDM. We administered standardized questionnaires to collect data regarding sociodemographic and clinical characteristics; collected vaginal samples at 26-38 weeks for Nugent scoring and determination of bacterial and fungal species; assessed AMR of the isolated pathogens and followed up patients for assessment of AFMOs.</p><p><strong>Results: </strong>We found AVF in 47.5% of participants, with 36.6% having single AVF and 10.9% mixed AVF. There was a significantly higher occurrence of all studied AVF subtypes in GDM group. We noted high prevalence of AMR and MDR among isolated pathogens. We also found association of AFMO with different AVF subtypes, with higher prevalence of AFMOs among participants with mixed AVF.</p><p><strong>Conclusion: </strong>The impact of AVF on AFMOs, along with their association with hyperglycemia; provides a potential avenue for working on minimizing AFMOs, which will eventually contribute toward improving the health of both the women and their offspring. The high prevalence of AVF and AMR in this study, calls for effective infection control and stewardship programmes.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13224-024-02095-0.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"494-503"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103028","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":"Pre-invasive Lesion of Cervix Among Healthy and Immune Compromised Individuals Using Histopathological Examination: A Hospital Based Cross-Sectional Study.","authors":"C Suhashini Karnal, S Sampathkumari, Sravani Chithra, K Alagu Sakthi Sowparnika","doi":"10.1007/s13224-024-02017-0","DOIUrl":"10.1007/s13224-024-02017-0","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is the one of the most constantly diagnosed and leading cause of cancer death in women, with an estimated 604,000 new cases and 342,000 deaths worldwide. One woman dies of cervical cancer every 9 min in India. Despite its high incidence, the knowledge and awareness regarding cervical cancer and its screening is limited. This study aims to estimate the proportion of preinvasive lesions of cervix among healthy and immunocompromised individuals.</p><p><strong>Methods: </strong>An observative cross-sectional study done in a tertiary care centre from January 2021 to June 2022 among 250 normal and 250 immunocompromised individual's attending tertiary care centre. Coloscopy guided biopsy was taken for histopathological examination after informed and written consent.</p><p><strong>Results: </strong>The proportion of preinvasive lesion of cervix among 500 individuals is 8.2% (41). The proportion of preinvasive lesion among normal individuals is 5.2% (13) and among immunocompromised individual is 11.2% (28). Most of the positive cases, 46% (19) were seen in women with more than two children. 75% (31) of positive cases were seen in women who had their first coitus at age less than 21 yrs. 87.8% of positive cases were seen in women not using any method of contraception.</p><p><strong>Conclusion: </strong>Preinvasive lesions are more common in immune compromised and it is precisely clear that all women must undergo cervical cancer screening as cervical cancer is the most common among women. \"Prevention is better than cure\"-Screening and early treatment of preinvasive lesion is cost-effective way to prevent cancer cervix.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"106-112"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103168","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":"Bariatric Surgery during Undiagnosed Early Pregnancy: Challenges and Outcome.","authors":"Neena Malhotra, Saloni Kamboj, Soni Bharti, Richa Vatsa, Riya Bagdi, Vidushi Kulshrestha","doi":"10.1007/s13224-024-02066-5","DOIUrl":"10.1007/s13224-024-02066-5","url":null,"abstract":"","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"631-634"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103222","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":"Gynaecological Disorder with Rare Para-Bombay Phenotype: Challenge in Transfusion Support.","authors":"Nirupama Sahoo, Sukanta Tripathy, Soumya Ranjan Panda, Jyochnamayi Panda, Suman Sudha Routray, Abhra Barman, Sasmita Dash","doi":"10.1007/s13224-025-02114-8","DOIUrl":"https://doi.org/10.1007/s13224-025-02114-8","url":null,"abstract":"<p><p>Transfusion management in patients with rare blood group phenotypes is a special challenge, especially in surgical cases. We report here the case of a 51-year-old female patient presenting with a huge pseudo-broad ligament fibroid and rare blood group phenotype. Initial serological testing during preoperative workup of the said case revealed BG discrepancies characterized by the O group on cell typing with an extra reaction with pooled 'O' cells on serum typing. A pan-agglutination pattern in antibody screening coupled with a negative direct antiglobulin test and auto-control indicated a Bombay or para-Bombay phenotype. Use of anti-H lectin, saliva secretor study, and antibody screening with cord O cells (Oi) aided in identifying para-Bombay phenotype. Transfusion support in this patient was challenging due to the presence of an anti-IH antibody acting at 37°. One of the major challenges to perioperative care was the unavailability of compatible donor blood units. An autologous transfusion approach was therefore adopted. After the uneventful surgical excision of the fibroid with minimal intraoperative blood loss, one unit of autologous blood was transfused to the patient. This case exemplifies the importance of comprehensive pre-transfusion testing and meticulous planning for patients with rare blood group phenotypes in order to minimize the risk of transfusion reactions and optimize surgical outcomes. Because the rare phenotype of the para-Bombay and transfusion are often problematic, rare donor registries and a heightened degree of clinical awareness will serve to improve patient safety in these instances.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 2","pages":"166-169"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060191","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":"Evaluation of Dietary Inflammatory Index (DII) and Healthy Eating Index (HEI) in Infertile Women with Polycystic Ovary Syndrome: A Case-Control Study.","authors":"Ava Hemmat, Nayere Khadem Ghaebi, Mohsen Nematy, Faezeh Mashhadi, Maryam Emadzadeh, Mohammad Reza Shadmand Foumani Moghadam, Fatemeh Roudi","doi":"10.1007/s13224-025-02111-x","DOIUrl":"https://doi.org/10.1007/s13224-025-02111-x","url":null,"abstract":"<p><strong>Background: </strong>Global infertility affects over 186 million women, posing significant health and societal challenges. Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder among reproductive-aged women, often characterized by inflammatory dysregulation. Dietary factors exacerbate insulin resistance and ovulatory dysfunction in PCOS through heightened inflammation. Improving diet quality may mitigate hyperinsulinemia, hyperandrogenism, and inflammation, thereby reducing complications such as infertility. This study examines diet quality using the healthy eating index (HEI) and the dietary inflammatory index (DII) in women with PCOS experiencing infertility.</p><p><strong>Methods: </strong>This case-control study enrolled 80 infertile patients diagnosed with PCOS, alongside 80 healthy individuals without PCOS. Dietary inflammatory Index (DII) and healthy eating index (HEI) scores were computed using a 168-item food frequency questionnaire. Spearman's correlation test was employed to assess variable relationships, and logistic regression was conducted to identify factors influencing PCOS risk.</p><p><strong>Results: </strong>PCOS patients exhibited higher mean DII scores compared to controls (- 2.24 ± 0.80 vs. - 2.57 ± 0.93) and lower HEI scores (55.74 ± 4.89 vs. 58.64 ± 7.16). Adjusted analyses revealed significant inverse relationships between dietary inflammatory and health indices and PCOS risk. Comparison with CRP levels showed significant associations (<i>P</i> < 0.001), but not with other biochemical markers or insulin resistance (TYG index) (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>This study highlights the significant associations between DII, HEI, and the risk of infertility and PCOS. Improving diet quality may mitigate inflammation and associated PCOS complications, offering potential avenues for intervention and prevention strategies.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 2","pages":"133-141"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055676","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":"Environmental Pollution and Reproductive Health: The Cause for Concern.","authors":"Hiralal Konar","doi":"10.1007/s13224-025-02128-2","DOIUrl":"https://doi.org/10.1007/s13224-025-02128-2","url":null,"abstract":"<p><p>Currently, there is a growing concern for human health with the rise of environmental pollution. Water contamination and health problems had been understood. Sanitation-related health issues have been overcome in the greater part of the world. Progressive industrialization has caused a number of new pollutants in water and in the atmosphere. It is a growing concern for the human health, especially upon the reproductive health. Current researchers provide a strong association between the rising concentrations of ambient pollutants and the adverse health impact. Furthermore, the pollutants have the adverse effects upon reproductive health as well. Major concern is for the health of a pregnant woman and her baby. Maternal-fetal inflammatory response due to the pollutants affects the pregnancy outcome adversely. Preterm labor, fetal growth restriction, intrauterine fetal death, and stillbirths have been observed. Varieties of pathological processes including inflammation, endocrine dysfunction, epigenetic changes, oxidative and nitrosative stress, and placental dysfunction have been explained as the biological plausibility. Prospective studies (systematic review and meta-analysis) have established that exposure to particulate matters (PM) and the nanoparticles (NP) leads to excessive oxidative changes to cause DNA mutations, lipid peroxidation and protein oxidation. Progressive industrialization and emergence of heavy metals, micro- (MP) and nanoparticles (NP) in the atmosphere and in water are the cause for concern. However, most of the information is based on studies from industrialized countries. India needs its own country-based study to have the exact idea and to develop the mechanistic pathways for the control.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 2","pages":"101-105"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042730","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":"Two Decades After Rotterdam Consensus: A Proposed Novel Evidence-Based Practical Modifications.","authors":"Mohammad Emam, Reda Hemida","doi":"10.1007/s13224-024-02067-4","DOIUrl":"https://doi.org/10.1007/s13224-024-02067-4","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is the most common endocrinopathy, affecting women, from adolescence to postmenopause. For two decades; PCOS has been defined in reproductive age group by the presence of two of three criteria according to Rotterdam criteria.The aim of this document is to highlight the pitfalls and drawbacks of Rotterdam criteria for diagnosis of PCOS after 20 years of application in clinical practice and to propose a novel evidence-based practical modification of these criteria.</p><p><strong>Conclusion: </strong>After two decades of Rotterdam consensus, the diagnostic criteria of PCOS could be modified and revised based on evidence-based guidance into three groups: reproductive age, adolescent, and postmenopausal group. The spectrum of PCOS should start from isolated polycystic ovarian morphology, i.e., without hyperandrogenism (HA) and ovulatory dysfunction (OD) to full-blown phenotype (PCOM + HA + OD). Furthermore, each group could be subclassified into obese or lean with presence of IR or not.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 2","pages":"179-181"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042732","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":"Prospective Study on Prevention of Post-Caesarean Endometritis by Vaginal Preparation with Povidone Iodine 1% Preoperatively in a Rural Tertiary Hospital in Central India.","authors":"Pradeep Biswas, Pramod Kumar, Shreya Sharad Mor, Shuchi M Jain, Priyanka Tripathi","doi":"10.1007/s13224-024-02045-w","DOIUrl":"10.1007/s13224-024-02045-w","url":null,"abstract":"<p><strong>Background: </strong>There is trend towards increased caesarean deliveries in the modern era. One of the most common negative effects of caesarean births is post-operative infectious morbidity. In addition to antibiotic prophylaxis, it has long been advised to prepare the surgical site with povidone-iodine to reduce presence of bacterial and fungal organisms near the skin or vagina. We thus concentrated on researching use of 1% povidone iodine vaginally preoperatively to prevent post-caesarean section endometritis in our hospital.</p><p><strong>Methods: </strong>This was a prospective, observational, case-control study. All pregnant women undergoing LSCS fulfilling the inclusion criterion were recruited and divided into two groups. All characteristics were recorded in specially designed Case Report Form, and patients were reviewed for 6 weeks for outcome measures. The data were analysed using Excel sheets, and Chi-square test and independent sample t-test were applied to analyse the statistical significance.</p><p><strong>Results: </strong>The cases were found to have undergone significantly greater mean number of pelvic examinations than the controls (<i>p</i> value < 0.0001). Greater proportion of controls developed endometritis and fever than the cases, and this value was statistically significant (p < 0.05). Wound infection and post-LSCS CRP levels were greater among controls as compared to cases, but this was not statistically significant.</p><p><strong>Conclusion: </strong>Incidence of post-caesarean endometritis and fever was significantly lower among cases as compared to controls. Application of povidone iodine is a simple and cost-effective method which can be implemented on a larger scale in order to reduce caesarean related morbidity.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"437-442"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103113","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":"Provision of Sensitive Medico-Legal Care to Sexual Violence Survivors in a Tertiary Public Health Facility of Maharashtra.","authors":"Shrinivas N Gadappa, Sonali S Deshpande, Rupali A Gaikwad, Sanjida Arora, Meghana Gaddikeri, Kavya Muralidhar, Ajinkya Deshmukh","doi":"10.1007/s13224-024-02042-z","DOIUrl":"10.1007/s13224-024-02042-z","url":null,"abstract":"<p><strong>Background: </strong>Healthcare providers play an important role in responding to violence against women. The healthcare providers have an important role as expert witness in trials related to sexual violence. In India, several policy and legal reforms like MoHFW guidelines and Criminal Law Amendment have been done to establish a sensitive response to survivors of sexual violence. However, several gaps continue to exist in health systems' response in cases of sexual violence. To fill this gap, this paper presents the findings from a tertiary health facility which has implemented evidence-based standardized guidelines for providing care to sexual violence survivors.</p><p><strong>Methods: </strong>The study was carried out in the OBGY department of a tertiary public health facility of Aurangabad, Maharashtra. The findings are based on the analysis of medicolegal records of 78 cases of sexual violence which came to hospital over a period of 6 months. The information about the profile of survivors, nature of violence, health consequences and compliance to standardized guidelines for medico-legal care was assessed. Additionally, the study also presents findings from in- depth interviews with trained doctors to understand their experiences of providing care and testifying in court in cases of sexual violence.</p><p><strong>Results: </strong>About 42% of survivors were adult and majority of them gave history of violence from a known abuser (83%). In 82% cases, the survivors reported penetrative sexual violence. The analysis of records indicated sensitive medico-legal care in form of operationalization of informed consent in all cases, collection of relevant samples for evidence collection (93%), and mention of irrelevant comment on hymen in 10 cases. The interviews with providers indicated the need to sensitize police and judges about relevance of medical evidence.</p><p><strong>Conclusion: </strong>Inservice training of HCPs and system level changes are essential for sensitive medico-legal care.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"152-158"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103185","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":"Incidentally Detected Transient Abnormal Myelopoeisis in a Placenta of Mosaic Down's Syndrome: A Case Report Describing Approach to Diagnosis.","authors":"Kriti Chauhan, Meenakshi Lallar, Aastha Sharma","doi":"10.1007/s13224-025-02107-7","DOIUrl":"https://doi.org/10.1007/s13224-025-02107-7","url":null,"abstract":"<p><p>Examination of the placenta is the easiest and the most cost-effective method to evaluate fetal abnormalities which might be missed by other antenatal screening techniques. Transient abnormal myelopoeisis (TAM) in placenta is one such condition which is specific for trisomy 21. Its relevance especially lies in cases where phenotypical features of down's syndrome are absent in fetus or the cytogenetic reports are negative, suggesting either confined placental mosaicism or low expression generalized mosaicism. This is imperative in parents' counseling and deciding further patient management because though TAM is a transient phenomenon, it may relapse or progress to acute leukemia.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 2","pages":"170-175"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021305","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}