Long anovulatory periods with unopposed estrogen stimulation may result in endometrial hyperplasia, thus increasing the risk of endometrial cancers. Therefore,

Background: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity worldwide. In India, they account for the third most important cause of maternal mortality. The objectives of this study were to evaluate maternal and perinatal outcome and complications in cases with severe preeclampsia and eclampsia. Methods: A retrospective study was carried out on 110 women with severe preeclampsia and eclampsia in a tertiary care referral centre over a period of 15 months. Only those cases with initial B.P reading of ≥160/110 mm Hg or presenting with eclampsia were included in the study. Investigations and management were carried out as per standardized department protocol and maternal and fetal outcomes were analyzed. Results: 42% of the cases were in the age group of 26-30 years, nearly 61% were primigravidae and the majority (64) were referred from peripheral hospitals. Liver function tests were deranged in 19% of the patients and 17% had abnormal renal function. Nifedipine was the most commonly used antihypertensive and magnesium sulphate was the anticonvulsant used in all the cases. Lower segment caesarean section was the mode of delivery in 64.5% of the cases. Commonest maternal complication was atonic PPH. There was no maternal mortality but there were 3 maternal near-miss cases due to DIC. 65% of the cases had a preterm delivery and 39% of the babies needed NICU admission. There were 10 neonatal deaths. Conclusions: Accessible health care and health education and awareness regarding antenatal check-ups for all women will lead to early detection of severe preeclampsia. Prompt treatment and management of its complications will certainly improve the maternal and fetal outcome.

Background: High-risk pregnancy is one in which the mother, foetus or the newborn has an elevated risk of experiencing an adverse outcome. These high-risk women form a special vulnerable cohort that can be identified in the antenatal period using a simple, easy to use, cost-effective tool- a maternal risk scoring system. Early identification of these high-risk mothers will facilitate effective intervention strategies to deal with the complications.Methods: This study was carried out on 300 pregnant women with gestational age more than 28 weeks. Detailed history, examination and necessary investigations were done and then using the Modified Coopland scoring system, each pregnant woman was assigned a risk score and stratified into 3 risk groups- low risk (0-3), moderate risk (4-6) and high risk (≥7) and followed up till delivery and 7 days postpartum. Subsequently, the maternal and perinatal outcomes were compared with their respective scores.Results: In this study, 14.66% patients belonged to the high-risk category. Statistically, a significant difference was noted in the number of low-birth-weight babies, in 5 minutes APGAR score <7 and in NICU admissions in the high-risk group compared to the low-risk group. Overall perinatal mortality was 13.33/1000 live births. In the high-risk group, a significant difference was seen in the occurrence of PPH and the need for operative delivery.Conclusions: Significant association between high-risk pregnancy and the poor maternal and perinatal outcome was noted. Therefore, a simple, cost-effective high-risk pregnancy scoring system such as the one proposed in this study can be used to identify potential high-risk pregnancies, provide them with tertiary care facilities and also corrective measures can be undertaken to prevent or minimize the complicating factors.

Background: Pelvic mass lesions are a commonly encountered entity in gynecological practice. These masses may be uterine or adnexal, benign or malignant. Clinicians have to be aware of their differential diagnosis to triage the patients and ensure optimum therapeutic approach. The objectives of this study were to study the diverse clinical spectrum of gynecological pelvic masses and to correlate the preoperative diagnosis based on clinical examination and ultrasonography with intraoperative surgical findings and histopathological examination.Methods: This was a cross sectional observational study on 114 patients with a diagnosis of pelvic mass who underwent laparotomy. All the patients were evaluated by a complete history, general abdominal and pelvic examination, followed by ultrasonography. These preoperative findings were then correlated with surgical findings and histopathological diagnosis.Results: 48% 0f the patients were in the age group of 41-50 years. The most common presenting complaint was lower abdominal/ pelvic pain seen in 78% of the patients. Uterine masses mostly presented as abdominal pain, abdominopelvic mass, menstrual complaints whereas ovarian masses presented with vague G. I symptoms or were asymptomatic. 37% of all masses were leiomyomas. There were 16 uterine malignancies and 14 ovarian cancer cases. Preoperative USG correlated well with histopathological diagnosis.Conclusions: A methodical approach consisting of a proper history, clinical examination, imaging studies and correct interpretation of diagnostic procedures is necessary for the triage and optimum management of gynecologic pelvic masses.