Journal of Obstetrics and Gynecology of India最新文献

{"title":"Integration of Prenatal Sonography, Fetal Autopsy, Histopathology and Genetic Tests in Anomalous Fetuses and Diagnostic Yield.","authors":"Suchandana Dasgupta, Neha M Bhagwati, Ana Fatima, Poornima Sharma, Shreya Singh Kushwaha, Renu Arora, Charanjit Ahluwalia, Sumitra Bachani","doi":"10.1007/s13224-025-02104-w","DOIUrl":"10.1007/s13224-025-02104-w","url":null,"abstract":"<p><strong>Background: </strong>Congenital abnormalities or birth defects occur in approximately 2-4% of live births. These birth defects can commonly occur due to genetic association, infections, nutritional, environmental factors or multifactorial. Role of ultrasound in detecting these anomalies is already established. Fetal autopsy is a valuable adjunct toward establishing the correct diagnosis and narrowing the field of investigations for a specific etiology.</p><p><strong>Methodology: </strong>A prospective observational study was conducted in Vardhman Mahavir Medical College and Safdarjung Hospital including 50 women who underwent termination of pregnancy due to prenatal ultrasound diagnosis of anomalous fetus. In 6% women who had advanced gestation beyond 24 weeks, termination was done after taking permission from medical board of the institute. All data were collected and agreement between initial ultrasound diagnosis and autopsy, histopathology and genetic testing was evaluated.</p><p><strong>Results: </strong>Among the study group 56% of women were between 20 and 25 years of age and 14% were a consanguineous couple. Recurrent anomalous condition was present in 8% fetuses. The most frequently involved system in this study was the urinary system (22%) followed by cardiovascular system (16%) and central nervous system (16%) equally. Multisystem involvement was identified in 10% on ultrasound. Autopsy added to prenatal ultrasound diagnosis in 54% cases, histopathology in 22%, prenatal or post-autopsy and histopathology-based genetic testing added to the diagnosis in 32% of cases.</p><p><strong>Conclusion: </strong>We conclude that autopsy, histopathology and genetic testing can significantly improve the diagnostic yield when performed all together or even in isolation.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"180-189"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103092","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":"Intrauterine Transfusion for Fetal Anemia: An 8-Year Experience from a Tertiary Care Center.","authors":"Zaneta Dias, Rinshi Abid Elayedatt, Anupama Karthik, Vivek Krishnan","doi":"10.1007/s13224-024-01985-7","DOIUrl":"10.1007/s13224-024-01985-7","url":null,"abstract":"<p><strong>Aim and background: </strong>To study the procedure-related complications and outcomes of intrauterine transfusion (IUT) in fetal anemia.</p><p><strong>Methods: </strong>A single tertiary care center, retrospective observational study of severe fetal anemia treated with IUT. The influence of gestational age (GA) at transfusion, hydrops, and route of transfusion on procedure-related complications were studied and the postnatal outcomes were recorded.</p><p><strong>Results: </strong> A total of 59 IUT's were performed in 33 anemic fetuses. Rh isoimmunization (30/33) was the most common indication in 90.9%. The mean GA of fetuses who developed procedural complications was 3 weeks earlier (Mean: 26 weeks) than in those in whom the procedure was uneventful (Mean: 29.8 weeks). The umbilical vein (UV) was the main route of entry in 86.4% of fetuses. All hydropic fetuses in the study needed an earlier transfusion than the nonhydropic ones. A total of six procedural complications were observed which varied from mild bradycardia (<i>n</i> = 1), intraperitoneal spill (<i>n</i> = 1), and preterm premature rupture of membranes (PPROM) (<i>n</i> = 1) to IUD (<i>n</i> = 3) of which with 2 IUD's, one PPROM and one intraperitoneal spill were seen in hydropic fetuses. The median age of delivery after IUT was 35 weeks. All neonates needed intensive phototherapy, 72% needed post-delivery transfusion, and 30% transfusion for late neonatal anemia.</p><p><strong>Conclusion: </strong>Early GA of transfusion and the presence of hydrops increased procedure-related adverse events. Small sample size and confounding factors like hydrops and early gestational age at transfusions made it difficult to comment on the influence of route on procedure-related complications.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"327-332"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103126","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":"Maternal Near Miss and Death Among Women with Eclampsia Using WHO Near Miss Criteria.","authors":"Debnath Ghosh, Snehamay Chaudhuri, Bheshna Sahu, Anwesha Chakraborty","doi":"10.1007/s13224-023-01931-z","DOIUrl":"10.1007/s13224-023-01931-z","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to estimate the prevalence of maternal near miss (MNM) and maternal death and to identify the factors associated with severe maternal outcome in women with eclampsia according to the World Health Organization (WHO) maternal near-miss criteria.</p><p><strong>Method: </strong>A cross-sectional study was carried out over a period of 12 months incorporating pregnant women diagnosed as eclampsia during antepartum and postpartum period. The definition of maternal near miss was applied according to the WHO near-miss criteria. Data were collected in a case record form specially designed for the study and analyzed using statistical software.</p><p><strong>Result: </strong>A total of 229 women with eclampsia included in the study over a period of 1 year. Among 229 women with eclampsia, 75 (32.75%) women diagnosed as maternal near miss (MNM), and 6 (2.62%) women had maternal death. Causes of near miss were neurological dysfunction (30.66%), respiratory dysfunction (24%), hematological dysfunction (18.67%), cardiological dysfunction (16%), hepatic dysfunction (10.67%) and uterine dysfunction (5.33%). Maternal near-miss ratio is 4.91 per 1000 live births, and severe maternal outcome ratio is 5.30 per 1000 live birth. Maternal near-miss mortality ratio (MNM:1MD) is 12.5:1, and mortality index is 7.40.</p><p><strong>Conclusion: </strong>The study shows that there is scope to improve antenatal care and utilization of health facilities. Early diagnosis, good perinatal supervision and appropriate treatment can ameliorate many cases.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"235-241"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103142","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":"A Randomized Controlled Trial Comparing the Efficacy of Bupivacaine Injection in Vaginal Vault and Paracervical Region Versus Vaginal Vault Infiltration with Bupivacaine After Total Laparoscopic Hysterectomy.","authors":"K S Kaloni, K K Roy, Deepali Garg, Avir Sarkar, Rinchen Zangmo, Anshul Kulshreshtha","doi":"10.1007/s13224-024-02086-1","DOIUrl":"10.1007/s13224-024-02086-1","url":null,"abstract":"<p><strong>Background: </strong>Demand for laparoscopic surgeries have been on the rise in all surgical departments in the past few decades. Hysterectomy, one of the most common gynaecological procedures is preferred laparoscopically these days owing to their multiple benefits.</p><p><strong>Aim: </strong>To compare the efficacy and safety of Bupivacaine injection in Vault versus Paracervical Block and Vault Infiltration with Bupivacaine after Total Laparoscopic Hysterectomy.</p><p><strong>Materials and methods: </strong>Thirty women undergoing total laparoscopic hysterectomy for benign gynaecology conditions were recruited and randomised into two comparable groups. Group I had 15 patients who received vaginal vault infiltration with 10 ml of 0.5% Bupivacaine. Group II had 15 patients who received paracervical block before surgery and vaginal vault infiltration after vault closure with 10 ml of 0.5% Bupivacaine. All patients were treated with injection paracetamol and NSAIDS. VAS score and need for additional analgesia were recorded at 1 h, 2 h and 6 h post-surgery. Any patient who reported a VAS score of more than 4 were given injection tramadol as rescue analgesia and recorded.</p><p><strong>Results: </strong>All the baseline characteristics were comparable except dysmenorrhoea (<i>P</i> = 0.017) and BMI (0.034) which showed statistically significant difference between the two groups. The VAS scores were significantly lower in combined group (Group I) when compared with vault infiltration group (Group II) across all time points (<i>P-</i> < 0.001). The need for rescue analgesia at 1-h post-surgery was lower in both the groups and comparable among the two groups (<i>P</i> = 0.483). The need for rescue analgesia at 2 h {<i>P-</i> < 0.001} and 6 h post-surgery {<i>P-</i> < 0.001} were significantly lesser in Group II (combined group). No patients required additional analgesia in group II.</p><p><strong>Conclusion: </strong>Two novel methods of administering local anaesthetic to alleviate post TLH pain when used in conjunction can significantly reduce pain and analgesia requirements making shorter hospital stay and early return to daily activities possible hence reducing cost per procedure.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"473-479"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103169","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 of Eating Disorders Among Patients with Polycystic Ovary Syndrome Presenting to a Specialty Hospital in Eastern India: A Cross-Sectional Study.","authors":"Sulagna Lala, Nrityendra Narayan Bhattacharya","doi":"10.1007/s13224-024-02089-y","DOIUrl":"10.1007/s13224-024-02089-y","url":null,"abstract":"<p><strong>Background: </strong>Mental health disorders accompanying polycystic ovary syndrome (PCOS) are important but underestimated aspects. There is paucity of literature (Indian) regarding the association of PCOS and eating disorders. Objectives were-(1) know the distribution of PCOS patients across sociodemographic variables-age, BMI and parity. (2) Know the distribution of PCOS patients according to menstrual history. (3) Know the relative frequency (percentage) of different eating disorders (binge eating disorder, bulimia nervosa and anorexia nervosa) in the study population. (4) Analyze association between eating disorders and PCOS in comparison with normal age-matched controls by eating disorder examination questionnaire (EDE-Q) scores.</p><p><strong>Methods: </strong>This institution-based cross-sectional observational study included consecutive 50 diagnosed PCOS patients of age 16-40 years giving explicit consent & equal number of age-matched controls. Patients with other concomitant diagnosed gynecological disorders and pregnancy were excluded. Study variables were-(1) age, (2) BMI, (3) parity, (4) menstrual status, (5) eating disorders and (6) EDE-Q subscale scores and global score.</p><p><strong>Results: </strong>Mean age of PCOS patients is 26.56 ± 4.33 years. Majority of PCOS patients were overweight, nulliparous and oligomenorrheic with binge eating disorder (52%). Majority of control women were overweight, nulliparous and eumenorrheic without any eating disorder (88%). Independent t-test showed statistically significant differences between PCOS patients with eating disorder and non-PCOS control women with eating disorder in EDE-Q global score and eating concern, shape concern and weight concern subscale scores, but no significant difference was observed in restraint subscale score.</p><p><strong>Conclusion: </strong>Statistically significant association found between PCOS and eating disorder across all domains except restraint domain. Therefore, it is important to raise awareness and provide education to women about disordered eating in PCOS. Formalized treatment guidelines, collaborative multidisciplinary effort and high degree of clinical suspicion are required in health professionals for timely diagnosis of both disorders to promote lifestyle management early on to prevent complications.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"221-226"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103219","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":"Critical Analysis of Peripartum Hysterectomies at Tertiary Care Centre of Northern India.","authors":"Manju Lata Verma, Sonia Prasad, Seema Mehrotra, Pushp Lata Sankhwar, Shyam Pyari Jaiswar","doi":"10.1007/s13224-024-02006-3","DOIUrl":"10.1007/s13224-024-02006-3","url":null,"abstract":"<p><strong>Aim: </strong>Peripartum hysterectomy is defined as removal of uterus at the time of delivery or in immediate postpartum period till 6 weeks. This study had been performed to critically evaluate the incidence, indications, maternal and neonatal morbidity and mortality associated with peripartum hysterectomies so that corrective measures both preventive and treatment may be implicated for benefit of women health.</p><p><strong>Method: </strong>A retrospective observational study in the Department of Obstetrics and Gynaecology, from 1st January 2013 to 31st December 2022, was conducted after obtaining ethical clearance. Information about all women, who had peripartum hysterectomy obtained from the medical case sheets, were recorded in a structured format which included demographic details, indication of peripartum hysterectomy, maternal and foetal outcome, per operative and postoperative complications, requirement of blood transfusion and need of ventilator support. Statistical analysis was done using the software package SPSS 28 for Windows.</p><p><strong>Results: </strong>Total 478 peripartum hysterectomies were performed during study duration. Incidence of peripartum hysterectomy at our centre was 6.4 per thousand deliveries. 45.8% (219/478) cases of peripartum hysterectomy had rupture uterus. Second most common cause was morbid adherent placenta which was in tune of 19%. Other causes were uterine atony, placenta previa and postpartum sepsis. 47.2% patients required ICU care, 1.25% had bladder injury, 10% had septicaemia, 0.8% required relaparotomy and 57.9% had still birth.</p><p><strong>Conclusion: </strong>Although peripartum hysterectomy is uncommon procedure but it is lifesaving procedure so every obstetrician must have expertise in this procedure.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"371-375"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103237","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":"An Asymptomatic Giant Endometrioma Presented as Lower Extremity Deep Vein Thrombosis with Early Pregnancy: A Case Report and Review of the Literature.","authors":"Shweta Alok Sonthalia, Junching Wong, Shalini Jain Agrawal","doi":"10.1007/s13224-024-02058-5","DOIUrl":"10.1007/s13224-024-02058-5","url":null,"abstract":"","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"619-622"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103194","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":"Incorporation of Mean Arterial Pressure in Clinical Practice Using Quality Improvement Initiative.","authors":"Sana Ansari, Reena Yadav, Nishtha Jaiswal, Kanika Chopra, Megha Kansara, Manisha Kumar","doi":"10.1007/s13224-024-02059-4","DOIUrl":"10.1007/s13224-024-02059-4","url":null,"abstract":"<p><strong>Objectives: </strong>To increase the practice of measuring mean arterial pressure (MAP) in pregnant women during antenatal check-up from 0 to 70% by 6 months.</p><p><strong>Methods: </strong>A quality improvement (QI) team ran multiple Plan-Do-Study-Act (PDSA) cycles. The process measure was two weekly assessments of improvement in MAP measurement. The outcome measure was the proportion of women started on aspirin. The pregnancy outcome of the low-risk and high-risk women were compared.</p><p><strong>Results: </strong>A total of 360 antenatal women were evaluated. With successive PDSA cycles, which included bridging knowledge gaps; involvement of a multidisciplinary team; involvement of supporting staff; application of software, the MAP measurement improved from 0 to 90% by the end of the study. Total 120/360 (33.3%) cases were deemed high risk based on the presence of maternal risk factors (OR -7.2 , C/I 1.43-36.50). The sensitivity, specificity, PPV and NPV of the test was 75.0%, 70.4%, 5.7%, 99.2% respectively. Total 14/120 (11.7%) cases at high risk of PE were started on aspirin. PE occurred in 6/106 (7.6%) women who were not on aspirin.</p><p><strong>Conclusion: </strong>The successful incorporation of MAP measurement in routine clinical practice could be done in a busy public hospital using POCQI.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"449-456"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103031","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":"Ovarian/Tubal Pathology in Premenopausal Women with Breast Cancer: A Prospective Study.","authors":"Sahana Punneshetty, Sherin Daniel, Shawn Thomas, Ajit Sebastian, Selvamani, Ashish Singh, Aaron Chapla, Sumita Danda, M J Paul, Anitha Thomas, Abraham Peedicayil, Rachel G Chandy","doi":"10.1007/s13224-024-02019-y","DOIUrl":"10.1007/s13224-024-02019-y","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer is most common cancer among women and hereditary mutations account for 5-10%. HBOC syndrome is most common hereditary mutation affecting breast & ovary. The prevalence of STIC lesions in these women ranges from 2 to 12% and that in general population is unknown. Role of risk reduction salpingo-oophorectomy (RRSO) is well established among these women. Surgical ovarian ablation also plays role in hormone positive breast cancers in prolonging their survival by permanent hormone suppression. The role of oophorectomy has different impacts in breast cancer.</p><p><strong>Methodology: </strong>The study aimed to determine the different indications for oophorectomy and their histologies among premenopausal breast cancer women. This was a prospective cross sectional study of breast cancer women diagnosed ≤ 50 years of age. All these women underwent genetic counselling, gynaecology examination, transvaginal scan &CA 125 testing. Surgery was offered to women with BRCA mutations (RRSO) and also for hormone receptor positive women (surgical ovarian ablation). Histopathologies of these women were analysed using SEE-FIM protocol.</p><p><strong>Results: </strong>A total of 98 breast cancer women were identified. The median age was 41.5 years (SD 5.7) & median CA 125 was 9.3 (IQR 6-20.5). The genetic acceptance rate was 18%. Four patients were germline BRCA 1/2 positive, 1 VUS, 13 negative and 80 didn't opt for test. Ultrasound imaging showed cystic ovaries among 12 patients. Most of them had benign features. Twenty two patients underwent surgery (bilateral salpingo-oophorectomy)-3 BRCA positive and rest for hormone positive breast cancer. Histopathologies were normal except for Krukenberg's mets in one hormone positive breast cancer patient.</p><p><strong>Conclusion: </strong>The incidence of germline mutations in our study was 5%. STIC lesions were not detected in our study, attributing to low acceptance of genetic testing. The value of screening for ovarian cancer was limited. Incorporation of genetics into routine gynaecology oncology clinic needs further addressal. Our study opened the doors for the genetic awareness among these young women.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"113-120"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103155","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":"Pregnancy Outcomes in Women with Complete Heart Block: Experience from a Tertiary Care Hospital.","authors":"Richa Vatsa, Ranjana Puleria, Vidushi Kulshrestha, Ajisha Aravindan, Soniya Dhiman, K Aparna Sharma, Vatsla Dadhwal","doi":"10.1007/s13224-024-02092-3","DOIUrl":"10.1007/s13224-024-02092-3","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy in women with complete heart block (CHB) poses a substantial challenge. We share our experience of managing pregnancies in patients with CHB.</p><p><strong>Methods: </strong>In this case series, outcome of 12 pregnancies in 10 women with PPM is studied. The presentation, need for pacemaker, and cardiac intervention were noted in patients with CHB. Mode of delivery, obstetric complications, and neonatal outcomes were compared with 24 low-risk pregnancies. Data analysis was carried out using SPSS software.</p><p><strong>Results: </strong>Syncope was presenting symptoms in seven (70%) women. Three women (30%) presented for first time during pregnancy. Out of 12 pregnancies in 10 women, eight pregnancies in six patients had a permanent pacemaker (PPM) from the start of pregnancy. Among rest four patients without a PPM, two (50%) needed pacing, one needed PPM in the second trimester, and one had a temporary pacemaker implantation (TPI) at the time of delivery. Obstetric complications and period of gestation were similar between cases and controls. The cesarean delivery rate was higher in patients with CHB, but the difference was not significant (75% vs. 37.5%, <i>p</i> = 0.07). None of the patients needed intensive care unit care. Mean birth weight was lower among cases (2443 ± 442 g vs. 3167 ± 434 g), but the incidence of fetal growth restriction was not different between cases and controls.</p><p><strong>Conclusion: </strong>Pregnancy in patients without PPM can be safely managed without pacing, with good obstetric and neonatal outcomes. Backup for TPI and/or cardiac interventions should be available during labor.</p>","PeriodicalId":51563,"journal":{"name":"Journal of Obstetrics and Gynecology of India","volume":"75 Suppl 1","pages":"480-486"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103165","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}