Aim To determine the current prevalence of thyroid dysfunction in normal pregnant women and to study the impact of thyroid dysfunction on maternal and fetal outcome. Methods 400 pregnant women between 13 and 26 weeks of gestation were registered for the study. Apart from routine obstetrical investigations, TSH tests were done. Free T4 and anti-TPO antibody tests were done in patients with deranged TSH. Patients were followed up till delivery. Their obstetrical and perinatal outcomes were noted. Results The prevalence of hypothyroidism and hyperthyroidism was 12 and 1.25 %, respectively. Adverse maternal effects in overt hypothyroidism included preeclampsia (16.6 vs. 7.8 %) and placental abruption (16.6 vs. 0.8 %). Subclinical hypothyroidism was associated with preeclampsia (22.3 vs. 7.8 %) as compared to the euthyroid patients. Adverse fetal outcomes in overt hypothyroidism included spontaneous abortion (16.6 vs. 2.39 %), preterm birth (33.3 vs. 5.8 %), low birth weight (50 vs. 12.11 %), intrauterine growth retardation (25 vs. 4.9 %), and fetal death (16.6 vs. 1.7 %) as compared to the euthyroid women. Adverse fetal outcomes in subclinical hypothyroidism included spontaneous abortion (5.5 vs. 2.39 %), preterm delivery (11.2 vs. 5.8 %), low birth weight (25 vs. 12.11 %), and intrauterine growth retardation (8.4 vs. 4.9 %) as compared to the euthyroid women. Conclusions The prevalence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening of thyroid dysfunction is recommended to prevent adverse fetal and maternal outcome.

A balanced approach to EOH can prove to be lifesaving at times when conservative surgical modalities fail and interventional radiology is not immediately available. Our study highlights the place of extirpative surgery in modern obstetrics in the face of rising rates of cesarean section and multiple pregnancies particularly in urban settings in developing countries.

Aim To assess the prevalence of vitamin D deficiency in burka-clad pregnant women and to study feto-maternal outcome in these women. Methods 200 pregnant burka-clad women of 18-40-year age group irrespective of the period of gestation were recruited from the ANC OPD/ward of Kasturba hospital, and their vitamin D levels were estimated. Patients were categorized into vitamin D deficient, vitamin D inadequate, and vitamin D adequate according to The Endocrine Society Guidelines. The association of vitamin D deficiency with dietary/environmental factors was taken note of. Associations with preeclampsia, gestational diabetes mellitus (GDM), low birth weight (LBW), prematurity, APGAR score, and NICU admission were also studied. Results 78 patients (39.0 %) were vitamin D inadequate; 75 patients (37.5 %) were vitamin D deficient; and 47(23.5 %) were vitamin D adequate. Mean value of vitamin D level was 23.25 ng/ml ± 18.49 (SD). Fifteen patients (7.5 %) developed preeclampsia, and all 15 were vitamin D deficient; 13 (6.5 %) developed GDM; and only 5 (2.5 %) of them were vitamin D deficient. 19 patients (9.5 %) delivered LBW babies; mothers of 15 (7.5 %) of them were vitamin D deficient. 12 patients (6.0 %) 123 delivered premature babies, and mothers of 4 (2 %) were vitamin D deficient; 12 babies had APGAR score \7 at 5 min; mothers of 4 (2.0 %) were vitamin D deficient. Babies of 12 patients (6 %) were admitted in NICU, and of these 12 babies, mothers of 5 (2.5 %) were vitamin D deficient. Conclusion The prevalence of vitamin D deficiency was high among burka-clad pregnant women, and it is associated with adverse maternal and fetal outcomes. Routine screening of vitamin D levels is recommended in burkaclad women to improve the feto-maternal outcome.

Background: the aim was to study the prevalence of abnormal thyroid function and thyroid autoimmunity in infertile women and in general population (control group) and to correlate the thyroid dysfunction with presence of anti-thyroid antibodies. It was a case control study. The study was carried out at Department of obstetrics and gynaecology, Kasturba Hospital, Delhi. Population of the study was fifty infertile women in whom other causes of infertility are excluded and fifty fertile women attending out- patient department with other complaints.Methods: All the women enrolled in the study were non pregnant, clinically euthyroid (with no signs and symptoms of thyroid disorders and no documented abnormal thyroid function test) and no known autoimmune disorder. Detailed history and a thorough general physical examination, including thyroid examination was done. Haemogram, blood group, fasting and post prandial blood sugar, VDRL, transabdominal ultrasound, TSH, free T3, free T4, and antithyroid per-oxidase antibody assay was done using the ELISA technique.Results: The mean age of the study group was found 28.38±2.45 years, 22% had abnormal thyroid function, 20% had antithyroid antibodies positive and the mean TSH of the study group was 4.61±1.72µIU/ml. The mean age of the control group was found to be 29.10±2.01 years, 12% had abnormal thyroid function, 10% had antithyroid antibodies positive and the mean TSH of the control group was 3.89±1.56µIU/ml.Conclusions: Thyroid dysfunction and anti-thyroid antibodies were more prevalent in patients with infertility. A statistically significant correlation was established between thyroid autoimmunity and thyroid dysfunction in infertile women in the study.

Purpose of the study- To study the efcacy of mifepristone followed by misoprostol over misoprostol alone in early pregnancy failure in terms of complete evacuation of uterus. METHODS: In a randomized comparative study at the Department of Obstetrics and Gynaecology of Kasturba Hospital, 100 women with early pregnancy failure and gestational age ≤12 weeks between January 2017 and December 2017 were recruited. Of these, 50 women were given a single oral dose of mifepristone (200 mg) followed by 800 mcg misoprostol vaginally (if required) after 24 hours and the other 50 women were treated with 800 mcg misoprostol vaginally alone. RESULTS: Complete evacuation of uterus was achieved in 96% women treated with a sequential combination of mifepristone and misoprostol versus 84% women treated with misoprostol alone. The difference in the rate of complete expulsion was 12% (p <0.05, 95% CI). Also, pre-treatment with mifepristone resulted in statistically signicant reduction in induction to abortion interval (2.40 ± 1.774 vs 3.30 ± 1.951 hr), amount of bleeding (402.2 ± 111.84 vs 535.0 ± 114.84 ml) and duration of bleeding (10.7 ± 2.30 vs 12.4 ± 3.38 days). CONCLUSION Medical treatment of early pregnancy failure with a sequential combination of mifepristone and misoprostol was more effective than misoprostol alone. Hence, women with early pregnancy failure may be offered mifepristone pretreatment before misoprostol to increase the chance of successful management, while reducing the need for surgery.

Introduction: The pathogenesis of fibroids has been hypothesized to involve a positive feedback loop between extracellular matrix production and cell proliferation, and vitamin D might act to block the positive feedback. Hence, this study was carried out to know the correlation of vitamin D levels with the size of fibroids. Methods: Seventy-five patients diagnosed with leiomyoma on ultrasound scan were labeled as the case group. Control group comprised of 75 women whose pelvic ultrasound was normal and there was no fibroid. On trans-vaginal sonography (TVS), we measured the volume of each of them. The quantitative detection of serum vitamin D levels was performed using a kit based on chemiluminescence in cases and control. Results: The mean value of vitamin D levels in cases was 12.58 + 4.09 ng/mL while in controls it was 18.99 + 5.72 ng/mL with p-value <0.001. Thus it was statistically significantly lower in cases than in controls. Pearson correlation of total volume of the fibroid (cm 3 ) and vitamin D level (ng/mL) was −0.292 with p-value of 0.011. Conclusion:The volume of fibroid and serum vitamin D levels are inversely related to each other, i.e., the less is the vitamin D levels, the more will be the volume of the fibroid.

We report a case of Harlequin ichthyosis (HI), extremely rare genetic disorder (1 in 300,000) with high (25%) recurrence rate in successive pregnancies. A preterm baby, born out of a consanguineous marriage, had all the features of HI (Figs. 1, 2). The underlying defect involves mutations in ATP binding cassette (ABCA12) gene responsible for transporting lipids to epidermal cells of skin.Note thick and fish-like scaly skin on the entire body separated by deep fissures, flat fontanel, ectropion, flattened nose, small nostrils, small ears, eclabium with open mouth, absent eyebrows, eyelashes, scalp hair, swollen extremities resulting in limitation of the joint mobility. There is no definitive treatment for HI other than supportive care. The newborn expired after 7 h in the neonatal ICU.

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