Objectives:To study the diagnostic accuracy of folliculometry and endometrial echo complex as an evidence of ovulation in infertility. Materials and methods:This clinical study was conducted on 100 infertile women. The women were subjected to follicular monitoring by transvaginal sonography (TVS) from cycle day 8 or 10 of menstruation with 7.5 MHz vaginal probe of Siemens ultrasound machine. Evidence of follicular growth, ovulation, and morphology of endometrial echo complex with its thickness was noted. Endometrial biopsy was performed premenstrually as a day care procedure after excluding pregnancy.Results: Out of 100 women, 81 cases were with evidence of ovulation on TVS and 68 were confirmed on histopathology. All the studied patients were also evaluated for endometrial thickness on the day of ovulation, echo complex of endometrium suggestive of ovulation was seen in 64 cases, out of these 59 cases were confirmed on histopathology. On histopathological study of 100 cases, we found 69 cases with secretory endometrium, 18 with proliferative endometrium, 10 patients with endometritis, one each with luteal phase defect, irregular shedding of endometrium, and hormonal imbalance. Conclusion:We found folliculometry predicted ovulation 86% accurately with a specificity of 58.60% and sensitivity of 98.55%. Similarly, appearance of endometrium predicted ovulation 85% accurately with a specificity of 83.80% and sensitivity of 85.50%. Thus, TVS has undeniable advantages in terms of cost, time, acceptability, risk, convenience, and could easily diagnose signs of ovulation in cases of infertility. The TVS has quintessential role as the first diagnostic modality in patients presenting with infertility.
Introduction: Cesarean delivery is a major obstetrical surgicalprocedure aiming to save the lives of mothers and fetuses.The incidence of cesarean section varies between 10.0% and25.0% in most developed countries.1Material and Methods: 80 cases for elective cesarean sectionadmitted in ward/labour room of Department of Obstt andGynae, SRMSIMS were studied to determine the incidenceof infectious morbidity, i.e., UTI, SSI, puerperal sepsis andendometritis on different occasions that are immediatepostoperatively, 48 hours post-operative, on discharge (4–5thday) and upto 6 weeks post-partum.Preoperative routine blood and urine examination were doneto recruit low-risk patients.Preoperative part preparation with betadine was done the nightbefore surgery, followed by intraurethral catheterization with 3swabs under all aseptic precautions.Results: There is a relationship between the timing ofadministration of prophylactic antibiotics and infectiousmorbidity. On comparing demographic factors concerninginfectious morbidity, a statistically significant p-value wasobserved with the women's age, parity and BMI.Conclusion: Single dose of prophylactic antibiotics shouldbe effective if given within 30 minutes of skin incision in anelective cesarean section, especially in women with mean age26.2 ± 4.2 years, low parity and with mean BMI of 24.9±2.4(kg/m2). The neonatal outcome is not much affected on givingprophylactic antibiotics before cord clamping. Despite ofprophylactic antibiotics aseptic technique during intraurethralcatheterization and check dressing at 48 hours postoperativelyof the surgical site is the most important factor in preventinginfectious morbidity.
Introduction: Abnormal Uterine Bleeding may occur in women of all age groups, responsible majorly (69%) in peri or postmenopausal age group. These complaints may significantly affect the quality of life, result in surgical intervention intending hysterectomy and ultimately have a significant impact on the health care system. Thus, there is a need for noninvasive or minimally invasive technique to study the endometrial pathology. The present study was designed to study the clinico-pathological correlation in abnormal uterine bleeding. Material and Methods: This study was a hospital based study, conducted in the Department of Obstetrics and Gynecology, SRMS IMS Bareilly. Around 150 patients with a clinical diagnosis of AUB were enrolled & were subjected for transvaginal ultrasound followed by endometrial sampling. Results: Majority of the patients were multiparous and in peri-menopausal age, presented menorrhagia being the most common pattern. More than half of the patients were obese. Simple hyperplasia and malignancy of endometrium was majorly seen among patients with endometrial thickness of >9mm. Conclusion:A visual assessment by the transvaginal sonography and histopathological assessment of the endometrium, remains the cornerstone in the current practice. Women with endometrial thickness of ≥ 8mm on TVS, can be further subjected for endometrial sampling and remaining women can be individualized for biopsy.
Aims and objectives: This study was aimed at comparing the various uterotonics in active management of third stage of labor and reducing blood loss. Materials and methods:A prospective study was conducted in the Department of Obstetrics and Gynecology of SRMSIMS, Bareilly, in 100 women. Patients were randomized into four groups of 25 each and were given oxytocic within 1 minute of delivery of the baby. Oxytocics used were 10 IU intramuscular oxytocin, 0.2 mg intravenous methylergometrine, 125 µg intramuscular 15-methyl PGF2-alpha and 600 µg tablet misoprostol per rectally in groups A, B, C and D respectively. Results:Duration of third stage of labor recorded was minimum with methergine with mean duration of 3.84 ± 0.99 minutes and was maximum with prostodin with mean duration of 5.04 ± 1.02 minutes. Amount of blood loss observed was minimum with methergine (mean 131 ± 72.037 ml) and maximum with Prostodin (mean 435 ± 147.578 ml). Hemoglobin drop was also seen maximally with prostodin with mean drop of 0.872 ± 0.458 gm% and minimally with methergine with mean drop of 0.236 ± 0.221 gm%. Change in the general condition of the patients in the form of tachycardia, fall in systolic and diastolic blood pressure was observed maximum with prostodin group whereas, in other groups, there was no significant change. Conclusion:It is concluded from this study that methergine is the uterotonic of choice followed by oxytocin for active management of third stage of labor.
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