Background: Hypertension is the most common medical disorder encountered during pregnancy, occurring in 6-8% of pregnancies. Women with hypertensive disorders of pregnancy (HDP) are all at increased risk of complications antenatally and in the puerperium.Objective: This study aimed to determine the maternal and perinatal outcomes of hospitalized pregnant cases with hypertension.Methods: This was a 3 years retrospective study conducted in a tertiary care centre of Northern India from July 2011 to June 2014. Maternal and Perinatal outcomes were compared among the HDP groups and results were analysed and tabulated by SPSS version, using chi square method.Results: Out of 2,989 deliveries during the defined period, the incidence of women presenting with HDP was 6.92% (n=207). Of these 50.2% (104/207) were pre eclampsia, 35.7% (74/207) eclampsia, 12.5% (26/207) were gestational hypertension and rest were chronic hypertension. The mean age of women presenting with HDP was 25.42 ±4.64 years. Co-morbid conditions like Gestational diabetes mellitus (GDM) was seen in 1.4% (3/207), twin pregnancy was seen in 5.79% (12/207) and obesity was seen in 7.24% (15/207) cases of HDP. There were 2 maternal deaths and 7 neonatal deaths. Maternal complications like acute renal failure (ARF), congestive heart failure (CHF), acute respiratory distress syndrome (ARDS) & disseminated intravascular coagulation (DIC) were seen more commonly in severe pre-eclampsia group. 62.8% babies (130/207) were premature. Poor neonatal outcome was higher in eclampsia group followed by severe pre-eclampsia group. Conclusion:A substantial burden of maternal and perinatal morbidity and mortality is associated with hypertensive disorders of pregnancy, more so in eclampsia and severe pre-eclampsia group as compared to gestational hypertension and mild preeclampsia.
Background: This study was designed to know the prevalence of hypothyroidism during pregnancy in western part of Uttar Pradesh and its potential complications. A prospective and comparative clinical study to know prevalence of thyroid disorder in pregnancy and pregnancy outcome was done.Methods: Eight Hundred eighty seven pregnant cases from Department of Obstetrics and Gynaecology, Chattrapati Shivaji Subharti Hospital, Meerut were enrolled in the study from the year 2018 to 2020. Detailed history and physical examination was done. Thyroid Function test (FT3, FT4, TSH and Anti-TPO) were performed after the confirmation of pregnancy. Patients were followed up during entire pregnancy. Thirty seven patients dropped out from the study.Results: In this study, prevalence of thyroid disorder was 27.28% which was high when compared to other regions in India and in other parts of Asia. Subclinical hypothyroidism and Overt hypothyroidism was 16.57% and 10.71% respectively. Subclinical hypothyroidism was more prevalent and hidden, leading to the poor obstetrical outcome and fetal complications. Rate of miscarriage was high in overt hypothyroid patients.Conclusions: Due to the immense impact that the maternal thyroid disorder has on maternal and fetal outcome, prompt identification of thyroid disorders and timely initiation of treatment is essential. Thus, universal screening of pregnant women for thyroid disorder should be considered especially in a country like India where there is a high prevalence of undiagnosed thyroid disorder.
Leiomyoma of the uterus is the most common tumor of the female pelvis and is seen in nearly half of the women above age 35. Large myomas with degenerations located towards the annexed may mimic an ovarian neoplasm and can impose a challenge in its diagnosis. We report an unusual case of a large, cystic, pedunculated uterine leiomyoma mimicking an ovarian tumor which misled the radiologist and the surgeon pre-operatively. As leiomyomas enlarge, they can outgrow their blood supply, resulting in various types of degeneration, such as hyaline, cystic, myxoid or red degeneration and dystrophic calcification. 3 Hyalinization is the most common type of degeneration, occurring in up to 60% of cases. Cystic degeneration is observed in about 4% of leiomyomas. Our case showed leiomyoma with both the secondary changes being reported on histopathology. The large size of the myoma, associated degeneration and its growth from the uterus towards the broad ligament laterally mimicked it to be an ovarian neoplasm. Fibroids masquerading as ovarian tumors impose a challenge to both the radiologist and the surgeon and should always be in the list of differentials. Magnetic resonance imaging although not the first choice, may be used if ultrasonography is inconclusive. However a stepwise and a multidisciplinary approach in management of these cases is preferred to achieve optimal results.
Background: The aim was to compare the diagnostic efficacy of ultrasonography (USG) and hysteroscopy in detecting uterine abnormalities in abnormal uterine bleeding (AUB) by correlating the results with histopathological examination.Methods: This prospective study was conducted among women attending gynecological OPD of Subharti medical college, Meerut over a period of two years from October 2019 to August 2021. A total of 100 perimenopasual women with AUB attending obstetrics and gynaecology OPD were included in this study. All patients underwent transvaginal scan to note down the endometrial thickness and to rule out uterine and adnexal pathology. All the patients underwent diagnostic hysteroscopy, followed by a biopsy of the endometrium using a curette. The endometrium was sent to the pathologist. Findings of these diagnostic modalities then correlated.Results: Out of 100 women, USG detected that 54 patients (54%) had no pathology and 46 patients (46%) had abnormal findings, out of which maximum patients, 29 patients (63.04%) had endometrial hyperplasia. According to hysteroscopy, 46 patients (46%) had normal hysteroscopic findings while 54 patients (54%) had abnormal findings of which maximum were 18 patients (33.33%) who had endometrial hyperplasia. Histopathology findings revealed that 47 patients (47%) had normal findings and 53 patients (53%) had abnormal findings out of which maximum patients 20 (37.7%) had endometrial hyperplasia. In our study of 100 women with AUB, on USG only 1 patient had endometrial malignancy and the same was reported by hysteroscopy and histopathology.Conclusions: In our study hysteroscopy proved to be highly sensitive and specific considering histopathology as gold standard. Ultrasonography has good sensitivity and specificity but less as compared to hysteroscopy.
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