Background: Abnormal Uterine Bleeding is a common complaint encountered in Gynaecology OPD. It occurs in 9-14% of women from Menarche to Menopause affecting quality of life imposing financial burden. Thyroid dysfunction causes broad spectrum of reproductive disorders from abnormal sexual development, menstrual irregularities, infertility and premature menopause. Thyroid disorders are 10 times more common in women and increased prevalence of thyroid disorders in women is possibly due to auto immune nature. Methods: This Prospective study population consisted of 250 women attending the Gynaecology Outpatient Clinic, in Government Dharmapuri Medical College Hospital, with complaints of bleeding problems during menstruation in the age group of 18 to 45 years. Results: Of 250 cases of abnormal uterine bleeding in reproductive age group attending the outpatient department about 68 cases have thyroid dysfunction. The common thyroid dysfunction in our study was hypothyroidism which comprises about 15.6% similarly other thyroid dysfunction are hyperthyroidism in 7.2% and subclinical hypothyroidism in 3.2% and subclinical hyperthyroidism 1.2%. Conclusions: It brings into focus the increased incidence of hypothyroidism among women with menorrhagia and amenorrhea. And increased incidence of hyperthyroidism in women with oligomenorrhea. Early detection by selective screening and specific pharmacotherapy for subclinical thyroid disease early in the course of the disease will prove to be a superior alternative to surgical treatments like hysterectomy.
INTRODUCTIONCaesarean section represents the most significant interventional operative procedure in all of obstetrics. Its development and meaningful application has helped us to provide safe motherhood and improved quality of life of mother and new born by avoiding serious delivery complications. The incidence of cesarean section has increased tremendously over the recent years. The rate of cesarean deliveries continues to increase despite efforts to constrain operative abdominal deliveries. This is a cause for concern because cesarean section is associated with higher likelihood of adverse outcomes for both mother and fetus as compared to vaginal delivery. There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity. Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient's majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications. Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.
Background: This study was undertaken to study the endometrial histology in patients presenting with abnormal uterine bleeding in the absence of palpable pelvic pathology, which helps in choosing the right modality of treatment in a particular age group with a specific histological change. The study of endometrium in dysfunctional uterine bleeding was undertaken to correlate clinical presentations with histopathological studies and to correlate the distribution of histopathological findings in various age groups.Methods: The present study was conducted in the Department of Obstetrics and Gynaecology at Govt. Dharmapuri Medical College and Hospital during the period 01.07.2017 to 31.05.2018. Patients presenting to Govt. Dharmapuri Medical College and Hospital with abnormal uterine bleeding form the material of this study. Cases have been selected by using purposive sampling technique.Results: An ovulatory cycles were more common than ovulatory cycles in all age group. However, in patients with menorrhagia and polymenorrhagia majority had secretory endometrium (ovulatory cycles).Conclusions: Majority of the patients were found in the reproduction age group with the maximum percentage in multiparous women. Menorrhagia was the commonest mode of presentation in all age group. Most of the patients with proliferative and secretory endometrium had normal sized uterus and normal looking endometrium.
Background: Multifetal gestation in addition to perinatal mortality and morbidity, attributable to preterm delivery they are more vulnerable to unique complications such as, structural malformations and twin- twin transfusion syndrome so that still birth rates are also appreciably increased. The incidence of multifetal gestation following conventional gonadtropin therapy is 16-40% with 75% being twins, with super ovulation it is 25-30%. The incidence of twins and triplets with embryo transfer 22-24% and 26% respectively.Methods: The clinical material taken from institute of Obstetrics and Gynaecology, Egmore Maternity, Chennai. Material for this study consists of 100 multiple pregnancies from May 2001 to April 2002. During this study period 19,617 patients admitted for delivery. There were 99 seats of twins and 1 Triplets.Results: During the period of 1 year, 150 cases were analyzed. During the period 148 cases 2 cases of tripelets studied, no cases of quadruplets were reported during this period.Conclusions: Multifetal gestation is one of the high-risk pregnancies. Hence women with multifetal gestation should ideally receive antenatal care in special twin clinics to meet their special needs. The multi-disciplinary team should be lead by an obstetrician, should include midwives, USG, Neonatologists, social workers and anesthetists. Women followed in twin clinic had significant improvement in women outcome which includes increased mean birth weight, decreased low birth weight and low ICU admissions.
Background: It has become common practice to discharge women from hospital early after caesarean section, to satisfy their wishes or to reduce workload the objectives of this study were to determine women’s satisfaction, and rates of wound infection, maternal readmission, and early postnatal depression. Postnatal hospital stay has two main objectives; the first, to identify any complication for both mother and newborn and the second, to provide the necessary support to the new mother for her return home. The two main reasons for this change in the service provided are to improve women’s satisfaction during this period and to reduce the cost to the health system.Methods: Retrospective study from January 2016 to January 2017 in a tertiary care hospital. Patient underwent Lower Section Caesarean Section (LSCS) were grouped into 2 groups. Group I- patients discharged on 5th post-operative day (POD). Group II-patient discharged at 8th POD. 500 patients were included in each group. Patient discharged on 5th POD was instructed about the warning symptoms of puerperium about fever, breast engorgement, wound discharge, foul smelling vaginal discharge, and advised for suture removal in nearby health facility.Results: Those who discharged at 5th POD (500) were followed through phone at 10th POD and only 498 could be traced and complications and satisfaction was made in discharge proforma. Of 500 patients discharge at 5th POD only 498 responded to phone call. Wound infection was found in 2 patients of those 2, both were asked to attend the post- natal clinic and found to have mild wound induration with minimal wound discharge which responded well to oral anti biotic and daily dressing in nearby health facility.Conclusions: In developing countries like India 70% of the patients undergo delivery in government hospitals. Most of them were belong to low socio-economic status and they have to go to daily work for their daily needs. If a patient is admitted for a prolonged period in a hospital the helping members who come to hospital, have to stay along with the patients and they will lose their daily income which will create debt to the family which in turn causes economic burden and psychological stress. This will reflect on the post-natal nutrition to the mother and baby.
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