Background and Aim: Ectopic pregnancy is assuming greater importance because of its increasing incidence and its impact on women's fertility. Present study was done with an aim to know the prevalence in the all the patients diagnosed with ectopic pregnancy at the tertiary care centre -G.K General Hospital Bhuj and patients referred from surrounding area for the same. Material and Methods: All patients diagnosed of ectopic pregnancy at tertiary care centre-G.K. General Hospital, Bhuj, Gujarat, India over a period of three months -July, August, September 2018 were enrolled in the study. Patients history was recorded and necessary investigation were done. Results: The incidence of ectopic pregnancy in this study is 3:187.5 amounting to 1.6% prevalence of ectopic pregnancy the mean age calculated is 24.08 years of presentation with maximum age being 35 years and minimum age being 19 years. Most of the patients -66.7% are primigravida patients, 8.3% second gravid and 25% third gravid. The aetiological risk factors in this study: 10% had conceived after ovulation inducing drugs, 30% had history of PID, 10% had history of surgery for an adnexal mass, with remaining 50% having no identifiable risk factors. Out of all cases-only two cases were brought in a state of shock with severe hypovolaemia which resulted in one maternal mortality as patient developed Acute STEMI due to coronary vasospasm, i.e 8.33% of all cases. Out of all cases 75% were ruptured ectopic pregnancy and only 25% unruptured ectopic pregnancies. Conclusion:The incidence of ectopic pregnancies is on the rise. All the cases were diagnosed with a high index of clinical suspicion and the USG findings added to the diagnosis. Though the recent trend in the management of ectopic pregnancy is the use of a conservative surgical or medical line of management, radical surgery or salpingectomy was the treatment modality which was used in the present study.
INTRODUCTIONInfertility is agonising condition and trauma of infertility is better felt and described by the infertile couple themselves. Infertility (subfertility) is defined as one year of unprotected intercourse without conception. Causes of female infertility are ovulatory dysfunction (20-40%), tubal and peritoneal pathology (30-40%), uterine pathology (uncommon) and unexplained. Overall fertility rates are 4-8% lower in women aged 25-29 years, 15-19% lower in aged 30-34%, 26-46% lower in women aged 35-39 years, 95% lower for women aged 40-45 years. Laparoscopy and Hysterosalpingogram are the two classic methods for evaluation of tubal and uterine factors. Laparoscopy is an important tool to assess the reproductive pathology including tubal patency (chromopertubation) in infertile women. It provides both panoramic view of pelvic anatomy and a magnified view of uterine, ovarian, tubal, and peritoneal surfaces and its pathology. Tuberculosis is an important health problem worldwide. One third of the world's population is currently affected with tuberculosis.In India, every year 1.8 million people develop the disease, of which 80,000 are infectious, 1000 die of it every day, with two deaths occurring every three minutes. Genital tuberculosis represents 15-20% of extra pulmonary ABSTRACT Background: Infertility is agonising condition. Tuberculosis is an important health problem worldwide. One third of the world's population is currently affected with tuberculosis. Hysterolaparoscopy is a well-recognized procedure for the diagnosis of infertility. Culture for TB bacilli is the gold standard for diagnosis of genital TB. Methods: Infertile women undergoing dilatation and curettage with hysterolaparoscopy with normal husband semen analysis as a part of their infertility workup at M. G. M. Medical Hospital, Kalamboli. Sample size: 30. Results: Incidence of GTB=22.85%, 25-29 year followed by 35-40 years' age group was the most common age group was observed. In our study, 74.3% infertility pattern was primary, 25.7% were secondary only 2.85 % (n =1) of the cases of GTB were diagnosed by using TB BACTEC. Laparoscopic findings su0ggested that 18 cases had normal findings and 8 cases had laparoscopic features suggestive of GTB. On chromo pertubation, delayed and absent spillage of the dye was seen in 2 cases. On Hysteroscopy, 29 cases (82.9%) of the patients had normal findings and 3 cases had Hysteroscopic features suggestive of GTB. Conclusions: Genital tuberculosis remains an important under diagnosed cause of infertility. Though culture is considered as gold standard for diagnosis of genital tuberculosis, since GTB is paucibacillary there is an urgent need for more research to come to conclusion whether culture is still gold standard. Further research is required to detect the most sensitive method for diagnosis.
In the current study we intend to measure the effectiveness and protection of high and low dose oxytocin for rise of labour, on process of delivery. Materials and Methods: One hundred pregnant women needed growth of labor forinadequate uterine contractions, even 1 hour after ARM [If membranes intact],and cervical dilatation is at least 3 cm or more. These cases were selectedrandomly and were assigned to either a low dose (2.5 mU/min) or a high dose(5 mU/min) regimen. Study included equal number of primigravida and multigravida in each group. Results: High dose oxytocin group was associated with significant shorter duration of labor, as indicated by shortened augmentation to full dilatation and augmentation to delivery gap in primigravidae contrast to low dose group, but not in multigravdia. Both in multigravida and primigravdia maximum oxytocin dose was high with high dose regimen compared to low dose. Conclusion: High dose oxytocin is better to low dose oxytocin for labour augmentation for efficient dystocia in primigravdia. High dose oxytocin augmentation in primigravdia is connected with considerable decrease in first stage of labour without any unpleasant perinatal and maternal morbidity or mortality.
Gastroschisis is a congenital anterior abdominal wall defect, adjacent and usually to the right of the umbilical cord insertion. Gastroschisis has no covering sac and no associated syndromes. This differentiates it from an omphalocele, which usually is covered by a membranous sac. G4P3L1D2 by date 37 weeks by scan 37 weeks (17.2) Ultrasonography S/O Gastrochisis delivered a male baby of 2.4kg and was shifted to the NICU. The exposed contents were given cellulose dressing. On post-natal day 2 baby was taken for abdominal wall repair. Baby was started on Ryle’s tube feeding and was further managed by the neonatologist.
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