Purpose of the Study To study the use of partogram in the analysis of spontaneous labour at term in primigravida with cephalic presentation. Methodology Partographic analysis of labour was done in 200 primigravidae. Partographic variables are plotted, and the study population was divided into three groups. Group I: Cervix dilatation and descent curve falling to the left of alert line; Group II: Cervix dilatation and descent curve falling to the right of alert line; and Group III: Cervix dilatation and descent curve falling to the right of action line. Maternal and neonatal outcomes were studied in each of three groups. Results Amongst the 200 primigravid labours analysed, 133 (66.5 %) belonged to group I, 40 (20.0 %) belonged to group II and 27 (13.5 %) belonged to group III. Mean durations of active phases of labour were 4.1 h, 6.9 h and 9.6 h, in groups I, II and III, respectively. In group I, 130 women (97.7 %) delivered vaginally, 3 (2.3 %) underwent LSCS. In group II, 29 (72.5 %) delivered vaginally, 4 (10 %) delivered instrumentally and 7 (17.5 %) underwent LSCS, and in group III, 5 (18.5 %) delivered vaginally, 7 (25.9 %) delivered instrumentally and 15 (55.5 %) delivered by LSCS. Conclusion Mean duration of active phase of labour increased as the partographic curve fell to the right of alert and action line. Increased rates of instrumental deliveries, LSCS, babies with lower APGAR score at 5 min, and NICU admissions were observed in group III compared with groups I and II.
Purpose of the Study This study is undertaken to emphasize the role of ultrasonography in the diagnosis of ectopic pregnancy and clinical analysis of the same in a tertiary care referral hospital. Methodology One hundred patients with provisional diagnosis of ectopic pregnancy were studied. Physical examination, urine pregnancy test, transabdominal scan using 5 MHz transducer or transvaginal ultrasonography of 7 MHz was done. The diagnosis of ectopic pregnancy was confirmed by direct observation by laparotomy or laparoscopy (which was taken as gold standard). Results The study showed ectopic pregnancy was most common in gravida 2 and in age group 26-30 years with most of them having married life \10 years. One or more risk factors were found in 66 % of cases. 54 % of cases presented with acute symptoms, 14 % of cases in shock. Among clinical presentation pain abdomen, history of amenorrhea, bleeding per vaginum, abdominal tenderness, and cervical motion tenderness was most common. In ultrasonography, complex mass in adnexa was present in 60 % of cases and hemoperitoneum in 50 %. 96 % of cases were tubal pregnancy with most of them tubal rupture. In 98 % of cases, radical surgery was done. Salpingectomy was the most common surgery done (90 %). There was no negative laparotomy in this study. There was no maternal mortality in this series. Conclusions In all the 100 cases of ectopic pregnancy studied, the ultrasonography provided definitive diagnosis resulting in 100 % sensitivity and 100 % specificity, predictive value of positive test being 100 %. Ultrasonography done in earlier weeks of gestation had sensitivity of 96 % and false negative 4 %.
Incidence of abnormalities of sex chromosome is reported to be 1 in 448 new born babies. The association between clinical phenotype and sex chromosome abnormality is highly variable. A 34-year-old unmarried female patient reported to out patient department with complaints of primary amenorrhea and occasional pain in the lower abdomen. On examination, her height was 160 cm and body mass index (BMI) was 27 kg/m 2 . Breast development was Tanner stage 4, pubic hair was tanners stage 1 and no axillary hair was noted. Ultrasonography showed a hypoechoic structure in the place of uterus measuring around 1.7 × 1.1 × 1.0 cm and hypoechoic structures were also noted in relation to iliac vessels suggestive of gonads. Karyotyping showed 46 XY and 47 XXY mosaicism. Bilateral gonadectomy was done and histopathology showed testicular atrophy with Leydig cell hyperplasia. This case is reported in view of the interesting clinical presentation of this rare mosaicism.
Partial vaginal agenesis with transverse vaginal septum is rare malformation of female genital system. The reported incidence of vaginal atresia is 1:4000 to 5000 live female birth. The incidence of septum in upper one-third is 46%, middle 35%, lower 19%. Transverse vaginal septum occurs due to defect in vertical fusion of mullerian ducts during embryogenesis. Vaginal atresia occurs due to failure of canalization of sinovaginal bulbs. We are presenting such a rare case of partial vaginal agenesis with transverse vaginal septum. The aim of this presentation is to make the consideration of transverse vaginal septum and vaginal atresia in young girls with cryptomenorrhea and to emphasize on is meticulous evaluation and diagnosis with counselling of a minor along with parents of future reproductive outcome along with surgical difficulties anticipation and difficulties post vangioplasty. How to cite this article Muralidhar L, Venkatesh S, Pandey P. Partial Vaginal Agenesis with Transverse Vaginal Septum. Int J Infertil Fetal Med 2014;5(3):110-112.
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