To determine the incidence of endometrial hyperplasia and endometrial cancer (EH/EC) in low-risk premenopausal women with abnormal uterine bleeding (AUB) undergoing endometrial biopsy and to build a predictive model that includes clinical variables for predicting EH/EC in these women. MethodsThis retrospective study was conducted between January 2015 and March 2020. All premenopausal women aged <55 years with AUB who underwent endometrial sampling during a specified time period were included. Data regarding baseline characteristics, sonographic findings, and histological reports were collected from patient record sheets. ResultsDuring the specified time period, 1,089 premenopausal women underwent endometrial biopsy for AUB. Complete data analysis was done for 1,084 women. Of the endometrial samples, 95.3% revealed benign pathology, whereas 4.7% of the samples had major endometrial pathology EH/EC. On step-wise logistic regression analysis, intermenstrual bleeding (IMB) (OR, 3.15), body mass index (BMI) >25 (OR, 4.4705), age >40 years (OR, 1.14), endometrial thickness (ET) >13 mm (OR, 2.5), and hypothyroidism (OR, 1.3) were significantly associated with EH/EC. Considering the pretest probability for an EH/EC of 4.7%, this prediction model with a likelihood ratio of 14.2% demonstrated a post-test probability of 41% in the presence of the above-mentioned variables. ConclusionThe risk of EH/EC was lower in low-risk premenopausal women with AUB. However, premenopausal women with IMB aged >40 years, hypothyroidism, BMI >25, and thickened endometrium (ET >13 mm) are at high risk of EH/EC; therefore, endometrial biopsy should be considered early in their management plan.

Background: Unregulated fertility not only disrupts the health of women and child but also disrupts the economy of society and nation. To gain the knowledge about awareness and contraceptive practices in women living in semi-urban area, a cross-sectional study was conducted over one year to evaluate the awareness, acceptance and prevalence of contraceptive methods and various factors affecting the contraceptive usage.Methods: It was a cross sectional study conducted in outpatient department of obstetrics and gynaecology, in a tertiary medical college hospital. The study constituted 300 subjects. It was an interview based study. Data were collected on age, parity, literacy level, residence, knowledge about various contraception, women practicing contraception and reasons for non-use of contraceptives.Results: A total of 300 women in the age group between 18-45 years were studied. It was observed that most of the women belong to the age group of 25 to 34 years (45.33%). 70% belong to rural population. only 20% were para 2 or less.35.33% of the study population were illiterate and 21.67% had education above secondary level. 290 (96.67%) women were aware of one or multiple methods of contraception however, 126 (42%) women accepted the contraceptive practices. Of 300 women, 94 (31.33%) followed permanent methods of contraception. 66% of the study population had experienced unwanted pregnancy and among them 44% pregnancies were aborted. Number of women practicing contraception was very low, i.e. 42% and the main reason of nonpractice of contraception was family pressure mainly in laws, husband gender bias, physical abuse, etc.Conclusions: It was noted that though knowledge of at least one method of contraception was wide among the women but still actual practice was very low. More programs are required to combat the influence of various factors on contraception usage, and emphasizing on the positive effects of the use of contraception.

No abstract

Cesarean scar pregnancy (CSP) is a potentially life threatening ectopic pregnancy where a missed diagnosis is commoner than an accurate diagnosis. Incidence of Ectopic pregnancy is 1 – 2 % and cesarean scar ectopic occurs in about (0.05%) 1 in 2000 of all pregnancies. With increasing cesarean section rates worldwide, CSP is bound to increase with its dreaded complications like uterine rupture and catastrophic hemorrhage. Three patients misdiagnosed as incomplete miscarriages in post cesarean pregnancies in other centers were found to be CSP in Gynaecology department of a tertiary level hospital. All three patients were managed successfully, two surgically and one medically.