Background: To study the role of hyperhomocysteinemia in unexplained infertility and the impact of its correction with vitamin and mineral supplementation. Methods: Total of 60 patients were included with 30 patients in case and 30 patients in control groups. Cases included patients with history of inability to conceive with frequent regular unprotected intercourse for at least 1 year. Controls included age matched parous females with at least one live birth and no history of abortions. Among the patients of unexplained infertility with hyperhomocysteinemia, homocysteine lowering agents were given and outcome studied in the form of lowering of homocysteine levels and number of conceptions. Results: The mean age was 28.1 years in study and 29.5 years in the control group .Mean level of serum homocysteine was significantly higher in study group than normal fertile women i.e.20.5µmol/l and 10.9 µmol/l respectively. Among the patients of unexplained infertility, 22(73.3%) were found to have range above the normal healthy levels. In these patients homocysteine lowering agents were given for 6 weeks and lowering of mean homocysteine levels was observed which was 10.4 µmol/l. Six (27.3%) patients conceived spontaneously during the follow up period. Conclusions: Serum homocysteine levels are inversely correlated with infertility. Homocysteine lowering agents have a favourable impact on the outcome of infertility and their use is suggested in cases of unexplained infertility associated with hyperhomocysteinemia. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000): 165-171
Background: To study the incidence, causes, clinical presentations, management and maternal morbidity and mortality associated with acute puerperal inversion of uterus. Methods: This retrospective study was conducted in Department of Obstetrics and Gynecology, G.S.V.M. Medical College, Kanpur, from March 2008 to March 2013. All the women who developed acute puerperal inversion of uterus either in or outside our hospital were included in the study. Results: Majority of women presenting with inversion belonged to age group 20-35 years, were multigravida (68.2%), came from rural set-up (81.4%) and were unbooked (81.8%). Majority of deliveries complicated by inversion took place at home (50%), delivered by dais (46%). Mismanaged 3rd stage of labour proved to be an important factor (36.4%) leading to inversion uterus followed by atonicity of uterus. 90% of women suffered due to delay in management at PHC and CHC, 68%women succumbed to delay in diagnosis at the place of delivery by untrained staff, whereas 45% women suffered due to delay in transport facility. 13.63% women suffered from sepsis in post-operative period, 22.72% from renal failure whereas 18.18% died. Conclusion: Proper education and training regarding active management of third stage of labour, diagnosis and management of uterine inversion should be imparted to traditional birth attendants, so that this potentially life-threatening obstetric emergency could be averted. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000): 292-295
INTRODUCTIONUterine rupture in pregnancy is a rare and often catastrophic complication. It is associated with a high incidence of foetal and maternal morbidity. Several factors are known to increase the risk of uterine rupture, these include poor socio-economic conditions uncontrolled fertility, illiteracy and unsupervised labour and contracted pelvis. Uterine rupture during pregnancy is a rare occurrence whereas uterine scar dehiscence is more common and seldom results in major maternal or foetal complication. The rate of caesarean has risen from 5% in 1970 to 26% in 2003 despite improvement in obstetrical procedures such as external version, total breech extraction etc.Incidence of rupture uterus is one in 1146 pregnancies i.e. 0.07%. The incidence of rupture remains high mainly due to the use of oxytocin drug by people not qualified for its use. Several studies suggest that for adequately screened women with prior caesarean section in trial of labour is safer than elective repeat caesarean section in hospital environment, but due to lack of health education, ignorance or poverty, women in our country do not come for regular antenatal check up preferring home delivery by traditional birth attendant, instead of coming to hospital for trial of scar. They were brought to hospital after prolonged dysfunctional labour when traditional birth attendant failed to deliver them. This results in increased chances of rupture of previous caesarean scar. High maternal mortality and morbidity rate is a consequence of poor maternal care, inadequate socio-economic and environmental conditions poor accessibility to health service and poor nutritional habits. Contributing factors are also extremes of maternal age and too many births with in short intervals.
ABSTRACTBackground: Uterine rupture a retrospective analysis of referral cases at a tertiary care centre in Kanpur city. Method: Observational study was conducted on 40 patients admitted Upper India Sugar Exchange Maternity Hospital, Kanpur. Result: Majority of patients presented with rupture uterus belongs to age group 30-35 years were multigravida came from rural setup and were unbooked among patients with lower segment rupture, 66.7% needed operative hysterectomy while 33% needed rent repair alone and were treated successfully. Conclusion: Uterine rupture is a catastrophic complication associated with high fetal and maternal morbidity and mortality.
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