Background: Oligohydramnios presents a threat to the fetus and has been correlated with increased risk of intrauterine growth retardation, meconium aspiration syndrome, severe birth asphyxia, low APGAR scores and congenital abnormities. It is associated with perinatal morbidity and mortality and maternal morbidity in a significant number of cases. Therefore, early detection of oligohydramnios and its management is important. Aim of this study was to know the fetal and maternal outcome in oligohydramnios.Methods: 90 patients in third trimester of pregnancy with Oligohydramnios were selected after satisfying inclusion and exclusion criteria. A detailed history and examination were done. All required investigation done. Oligohydramnios confirmed by measuring Amniotic fluid index (AFI).Results: Mean maternal age-26.1 years. Incidence of oligohydramnios was more in primipara (64.4%) in our study. And operative morbidity was also more in primipara (51.7%). Most common cause of Oligohydramnios was idiopathic (44.44%). Operative morbidity was significantly higher in Non-reassuring FHR (80%) than reassuring FHR (32%). 7 patients (7.78%) were found with fetoplacental insufficiency on Doppler study.Conclusions: Oligohydramnios is frequent occurrence and demands intensive fetal surveillance and proper antepartum and intrapartum care so that perinatal morbidity and mortality and maternal morbidity can be reduced.
Introduction Vaginal discharge is the most frequent complaint during pregnancy, leading to numerous complications in both the mother and fetus. Aim The goal of this study was to determine the prevalence of vaginal discharge, investigate its common infectious causes and associated symptoms during pregnancy. Methods This hospital-based cross-sectional study performed over one year evaluated 200 expectant mothers with vaginal discharge at any trimester in the Department of Obstetrics and Gynecology, in cooperation with the Microbiology section, of Indira Gandhi Institute of Medical Science, Patna. Results The mean age of the mothers was 26.84±5.51 years (range 19-42 years). Most of the patients (47.5%) were in the age group of 26-35 years, belonged to the lower socioeconomic class (67.5%), gravida 3 or more (43.5%), and presented in the third trimester. The prevalence of pathological discharge in pregnancy was 148/308 (48.05%). A positive culture was obtained in 105 (52.5%), and negative culture was obtained in 95 (47.5%). Vaginal candidiasis was diagnosed in most cases (37.5%), followed by aerobic vaginitis (15%), trichomoniasis (13.0%), and bacterial vaginosis (8.5%). The non-pathological discharge was diagnosed in 26.0%. Dysuria was the most common symptom (32.5%), followed by itching (27.5%) and urinary tract infection (UTI; 10.0%). The following variables were significantly associated (P<0.05) with discharge: age (in years), age group, gravida, culture, organism isolated on culture, UTI as a symptom, and diagnosis. Conclusion Expectant mothers presenting with vaginal discharge need to be evaluated to identify the etiology and allow timely treatment, which might be helpful in preventing complications.
Introduction: Pregnancy-related acute kidney injury (AKI) is a common occurrence and is associated with substantial maternal morbidity and mortality in developing countries. It may comprise up to 25% of the referrals to dialysis centers in developing countries. Acute kidney injury in pregnancy bears a high risk of bilateral renal cortical necrosis and consequently chronic renal failure. Study aimed to evaluate the contributing factors responsible for pregnancy-related Acute kidney injury and to assess the outcome of patients with pregnancy-related Acute kidney injury. Material and methods: The present study is a prospective study of patients with obstetric complications leading to Acute kidney injury admitted in Obs and Gynae Deptt and nephrology deptt of IGIMS for a period of one year. Pregnant women who are included in the study are those who were healthy previously and had developed Acute kidney injury-oliguria (Urine output <400 ml/d) and azotemia (Serum creatinine >2 mg%) due to pregnancy related complications. Results: Pregnancy related complications was present in 38 patients admitted in our hospital with acute kidney injury in one year period. Out of these 37% (14) of patients were in early stage of pregnancy while 63% (24) were in later stage of pregnancy and puerperium. Causes of AKI was post abortal sepsis in 23.6%, puerperal sepsis in 26.3%, haemorrhagic shock in 23.6%, eclampsia/pre-eclampsia/HELLP syndrome in 21%, IUD in 2 nd trimester with sepsis in 2.6% and acute fatty liver of pregnancy in 2.6% of cases. Sepsis was the major cause accounting upto 52.6% of cases. Approximately 52.6% (20) of patients improved on treatment and dialysis, 21% did not improve (8), 13.15% (5) died and 13.15% (5) left against medical advice. Cause of death in 80% (4 out of 5) of patients was sepsis. Renal biopsy was performed on 62.5% of patients who did not improve (5 out of 8 patients). Renal transplant was done in 1 patients. Conclusion: Obstetric AKI is still a critical situation in developing countries and rare entity in developed countries. Maternal mortality has decreased but sepsis still accounts for majority of cases. Therefore early diagnosis and treatment is the need of the hour.
Objective The aim of this study was to determine the perinatal outcome of pregnant patients complicated with meconium-stained amniotic fluid (MSAF) compared with clear amniotic fluid. Methodology This prospective cross-sectional study was conducted in the Department of Obstetrics and Gynecology in collaboration with the Department of Pediatrics at Indira Gandhi Institute of Medical Sciences, Patna, India, from September 2016 to January 2018. A total of 200 patients were included in the study after taking their written consent. Out of these 200 patients, 100 patients had MSAF, and the other 100 patients with clear liquor were taken as controls after fulfilling the inclusion and exclusion criteria. These two groups of patients were compared regarding various maternal and neonatal parameters. These parameters were compared and tested statistically for significance. Results Among the 100 patients with MSAF, 20 patients had grade 1 meconium (X), 22 patients had grade 2 meconium (Y), and 58 patients had grade 3 meconium (Z). The majority of patients in the MSAF group were primigravida and more than 25 years of age. In addition, 47% of patients in the MSAF group had some associated high-risk factors and 50% of patients had non-reassuring fetal heart rate patterns, and among these, 39 patients had grade 3 MSAF (X). In the MSAF group, 49% of patients had undergone lower segment cesarean section (LSCS), whereas in the non-MSAF group, it was 37%. Also, 30% of babies in the MSAF group and 13% in the non-MSAF group had neonatal intensive care unit (NICU) admission; 22% of babies in the MSAF group and 12% of babies in the non-MSAF group had an adverse neonatal outcome. Meconium aspiration syndrome was present in 14% of the patients in the MSAF group, and among these, two babies had neonatal death and both had severe birth asphyxia. In the non-MSAF group, there was one neonatal death due to neonatal sepsis. However, after statistically analyzing the neonatal outcome in both the groups, there was no statistical difference between the two groups (p<0.001). Conclusion MSAF is associated with increased frequency of operative delivery, poor neonatal outcomes, and increased NICU admission. Management of labor with MSAF requires appropriate intrapartum care with continuous fetal heart rate monitoring, and this can reduce unnecessary cesarean sections in patients with MSAF.
Introduction: Back in India, cervical cancer is the second most frequent cancer in women (aged 15–45 years) following breast cancer, accounting for nearly 14% of all female cancer cases. The aim of this study is to yell the findings of pap smear with colposcopy and directed biopsy (if needed) and to evaluate the usefulness of colposcopy in discovering the premalignant and malignant lesions of the cervix. Methods: This is a prospective observational analysis of 150 symptomatic women attending the gynecology OPD of Indira Gandhi Institute of Medical Sciences, Patna, for a period of one year from 2019 to 2020. Assessment of symptomatic women was completed with a pap smear, colposcopy, and biopsy in selected instances. Statistical Analysis Used: MS Excel spreadsheet application, SPSS v23 (IBM Corp.), was used for data analysis. Results: The expression age (years) has been 34.68 ± 8.05. The sensitivity and specificity of pap smear were 91.7% and 45.45%, respectively, whereas the sensitivity and specificity of colposcopy were 83.3% and 72.72%, respectively, in the present study. Conclusions: Pap smear had low specificity as compared to colposcopy. Hence simultaneous use of colposcopy has shown to rise in the rate of carcinoma cervix discovery in symptomatic women.
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