Background: Recurrent pregnancy loss (RPL) affects about 5% of women. High levels of homocysteine, termed hyperhomocysteinemia, have been implicated in a number of pathologic processes in the venous and arterial vascular systems. Hyperhomocysteinemia in pregnant women has been associated with deep venous thrombosis, recurrent miscarriage, abruption placentae, preeclampsia, neural tube defects, and fetal growth restriction. This study aims at determining association between hyperhomocysteinemia and recurrent pregnancy loss and also association of folic acid (vitamin B 9) and vitamin B 12 with hyperhomocysteinemia (HHCY), in reducing its levels in the body and thus preventing obstetric complications.Methods: A prospective study of pregnant mothers booked at our hospital over a period of two years with history of unexplained RPL were included in the study and their serum homocysteine levels were assessed. Hyperhomocysteinemia (>12 micromol/l) patients were treated with folic acid and vitamin B12 supplements and homocysteine levels were assessed again, post treatment.Results: Out of the 100 patients who were assessed, 32% of RPL patients had hyperhomocysteinemia. Folic acid and VitB12 supplementation reduced homocysteine levels and this was found to be statistically significant.Conclusions: Hyperhomocysteinemia is associated with RPL. Vitamin supplementation to those with hyperhomocysteinemia, decreases homocysteine levels.
Background: Perimenopause is the period surrounding menopause characterized by ovulatory dysfunction and menstrual irregularities. Taking into consideration the importance of perimenopause and its consequences, we decided to study this topic in order to know the different menstrual irregularities in relation to age, the spectrum of endometrial histopathology, in relation to various gynaecological conditions as per the PALMCOEIN classification of AUB.Methods: The study population comprised of 100 women in the age group of 40- 59 years who reported to our tertiary care centre of Armed Forces for evaluation of abnormal uterine bleeding. The study was a community based cross - sectional descriptive study. Patients were examined, using one of the three techniques – Dilatation and curettage, suction aspiration and hysteroscopy and endometrial biopsy.Results: Out of the 100 women evaluated for perimenopausal bleeding, heavy menstrual bleeding was the commonest in 53% cases. The maximum no. of cases was in 40-44-year age group (57.44 %). The clinical diagnosis of fibroid uterus was found in 45% cases, AUB (O) in 36% cases, AUB (Polyp) in 8% cases, AUB (Adenomyosis) in 9% cases and AUB (Malignancy) in 2% cases. On endometrial curettage, proliferative type of endometrium was found in 43% cases, secretory type in 18% cases and hyperplasia was found in 37% cases. Out of 2 cases of atypical hyperplasia 1 case each (50%) was found in the age group of 50-54 years and 55-59 years, respectively.Conclusions: In the present study, there was good correlation between abnormal uterine bleeding, clinical diagnosis and histopathological findings.
Background and objectives: Labor pain is a severe form of pain experienced by a woman, leading to tremendous stress. Several routes for labor analgesia have been tried. Entonox is a premixed homogeneous gas mixture of nitrous oxide and oxygen in the ratio of 50:50 providing conscious sedation in obstetrics during labor. It is a safe and effective analgesia for obstetrics use due to its properties of rapid onset, short half-life, and rapidly disappearing symptoms on withdrawal of the gas. Therefore, we aimed to evaluate the effect of Entonox on the severity and relief of labor pain during its various stages and its associated maternal or fetal side effects. Materials and Methods: A prospective randomized controlled trial (RCT) of 200 term pregnant mothers reporting in labor over a period of 2 months who were randomized into Entonox group and placebo oxygen control group was included in the study. Administration of both gases was done, and the pain scoring was recorded. Maternal and fetal complications were noted. Results: The intensity of labor pain was significantly lower in Entonox group as evident by lower pain scoring values. The mean duration of the active phase of labor in the Entonox group was comparable to the oxygen group. Maternal and fetal side effects were not significant in both groups. The mode of delivery is also comparable in both groups. Conclusion: Entonox usage in labor analgesia is a safe, effective, and inexpensive method of relieving labor pain, achieving immense patient satisfaction and making labor a pleasurable experience.
Background: There are various methods for induction of labour, both mechanical and pharmacological. Prostaglandins in induction have been commonly used. Studies have been done using vaginal and sublingual use of misoprostol. This study analyses efficacy of both oral misoprostol used in low frequent doses as per FIGO 2017 guidelines and intracervical prostaglandins for induction of labour.Methods: A total 159 consecutive pregnant term mothers with singleton pregnancy, intact membranes and unfavorable cervix were subdivided into two subgroups, first subgroup was administered 25 mcg oral misoprostol at 2 hourly interval and those in subgroup B were given intracervical PGE2. Both these subgroups were prospectively followed to assess efficacy in induction of labour at term and outcome in foetus and mother. Statistical analysis was done using chi square test.Results: It was found that the induction to delivery interval was significantly lesser in the cerviprime group (19.31 hours) compared to the misoprostol group (25.19 hours). However, there was no significant difference in the rate of vaginal delivery and mean duration of labour, rates of caesarean section, maternal and neonatal complications in both the groups. More women in the cerviprime group required augmentation with oxytocin. However, on comparing the cost of induction as per the mean doses used, the cost of induction with misoprostol was much lesser than that of cerviprime use.Conclusions: Oral use of Tab. misoprostol was not more efficacious than the use of cerviprime gel in induction of labour.
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