Gynaecological morbidities is any condition, disease or dysfunction of the reproductive system that is not associated with pregnancy, which includes reproductive tract infections, cervical cell changes, prolapse, urinary tract infection, back pain due to osteoporosis. 1 The community based prevalence of these morbidities are influenced by demographic, social, cultural and behavioural factors. Women do not consider it as a significant health problem or hesitate to talk about it. The onset of the menopause not only signals the end of a woman's reproductive function but also the start of a new ABSTRACT Background: Gynaecological morbidities is any condition, disease or dysfunction of the reproductive system that is not associated with pregnancy which include reproductive tract infections, cervical cell changes, prolapse, urinary tract infection, back pain due to osteoporosis. The community based prevalence of gynaecological morbidities are influenced by demographic, social, cultural and behavioural factors. Geriatric gynaecological problem especially in tribal population has not received adequate attention in India. It is a fact that, health seeking behaviour forms an important component in formulating health programs as successful interventions depends on the accessibility and acceptability ,both of which relates to social factors. The objective of this study was to assess the gynaecological morbidities of aged (>60 years) tribal women in Trivandrum district living in various settlement areas and also to study their health seeking behavior. Methods: 11 panchayats were selected where the density of tribal population was high, and using cluster sampling method, a sample size of119 was arrived at, and these many women were included in this study out of the total of 2362 aged tribal women residing in Trivandrum. 12 camps were conducted in settlement areas during the period of one year of study. Socio-demographic, general health, and gynaecological examination was conducted and findings noted in a proforma. Results: 47.1% women had one or more coexistent gynaecological morbidities. 16% had clinical evidence of vaginitis, 9.2% had urinary tract infection, 12.6% had prolapse of some degree, 3.4% had cervical lesions. 80% of tribal women belonged to low socio economic status. 74.8% tribal women were anaemic. However around 80% had health seeking behaviour. The rest did not seek because of inaccessibility or shyness to discuss gynaecological morbidities. Conclusions: Aged trial women harbour considerable gynaecological morbidities. Inspite of having a very high level of health seeking behaviour it was noted in the current study that the prevalence of anaemia was very high. Therefore there is an urgent need to further improve health facilities and health care in these areas.

Introduction Polycystic ovarian syndrome (PCOS) is an endocrine disorder affecting all age groups and presenting with myriad problems like menstrual irregularities, hirsutism, anovulatory infertility, and long-term complications like diabetes, cardiovascular problems, etc. Aim Study was aimed at finding the prevalence, characteristics, and various risk factors of metabolic syndrome (MS) in reproductive age group in our hospital. Materials and methods Using statistical table, a sample size of 131 was calculated and patients were recruited as per inclusion criteria. Polycystic ovarian syndrome was diagnosed by the American Society for Reproductive Medicine (ASRM)/European Society of Human Reproduction and Embryology (ESHRE) criteria. After informed consent, a detailed history was obtained and physical examination was carried out to assess, body weight, height, body mass index (BMI), waist—hip ratio (WHR), and blood pressure (BP). Fasting blood glucose, triglycerides, and high-density lipoprotein (HDL) were measured for each woman Results Prevalence of MS in our study was 45.8%; 26.7% of patients had a combination of increased waist circumference, raised triglycerides, and low HDL; 55.2% of patients had a fasting blood sugar (FBS) levels more than 100 mg%. Age of the patient was a statistically significant risk factor of MS with 100% of patients in the age group of 35 to 39 presenting with MC. Body mass index was also a statistically significant risk factor with 82.6% with BMI > 30 having MC. Other important risk factors include a WHR more than 0.95, presence of diabetes in mother or sister, and presence of acanthosis; 71% of patients with WHR more than 0.95 had MC. Age of menarche, duration of menstrual cycles, and hirsutism showed no significant relationship. Conclusion An outstanding fact that emerged in this study was that 94% of women with PCOS had HDL values <50 mg/dL. And 58% had triglycerides more than 150 mg/dL. Hence, lifestyle modification and early intervention will hopefully spare long-term complication of PCOS. How to cite this article Madusudhanan RR, Nambisan B, Brahmanandan M, Radha S. Study on the Prevalence and Characteristics of Metabolic Syndrome in Women of Reproductive Age Group with Polycystic Ovarian Syndrome. J South Asian Feder Obst Gynae 2017;9(4):341-347.

Background: Reduction of maternal mortality remains a challenge for developing countries like India as per the sustainable development goals put forward by UN. Near-miss audit is emerging as a new tool for setting new protocols in reduction of MMR. This study aimed, to analyze the near miss events and mortality events which occurred in the study setting from January 2011 to December 2012, and to compare the causes that led to the events.Methods: A descriptive comparative study was conducted at SAT Hospital, Government Medical College, Thiruvananthapuram, a tertiary care center in Kerala, India on the data accounted for a period of 2 years, 2011 and 2012. Maternal near-miss during the period is studied according to WHO 2009 criteria and compared with the maternal deaths during the same time period. The data was recorded using structured proforma; the same proforma was used to record maternal mortality cases of the same period.Results: Total live births during the time period were 18,663. Eighty-eight near miss cases and 26 maternal deaths occurred during the study period. Incidence proportion of maternal near-miss was 4.71/1000 live births. Severe maternal outcome was 6 per1000. For every maternal death, there were 3.38 near-misses. Mortality index of our institute was 22.8% and maternal mortality ratio (MMR) of the study setting was 139/1 Lakh live births. Post-partum hemorrhage was the leading cause for near-miss and systemic diseases were the major contributors to mortality.Conclusions: It is evident from the present study that PPH, once the leading cause of maternal mortality is now the leading cause of maternal near miss and by improving the resources of FRUs it can be further reduced. Systemic diseases are emerging as a new threat to the obstetric population leading to mortality.

BACKGROUND The coronavirus disease 2019 (Covid-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), is a global public health emergency. Data on the effect of coronavirus disease 2019 in pregnancy is limited to few case series. The purpose of this study was to describe the histopathological findings in the placentas of women with Covid-19 during pregnancy. METHODS Pregnant women with Covid-19 who delivered between August 1, 2020 and May 10, 2021, at Government Medical College, Trivandrum were considered for the study. Handling of specimens were carried out using Indian council of medical research (ICMR) guidelines for Covid-19 specimens. Placentas underwent routine clinical examination and processing. Clinical information was retrieved from the medical records. Histological examination was performed and features classified into maternal vascular malperfusion (MVM) and fetal vascular malperfusion (FVM). RESULTS 50 placentas from patients with severe acute respiratory syndrome coronavirus 2 were examined [33 patients delivered at term, 12 patients were preterm, 4 cases were intrauterine fetal demise and 1 case was medical termination of pregnancy (MTP)]. Patients with risk factors for maternal and fetal vascular malperfusion were excluded. 8 cases showed features of maternal vascular malperfusion and 11 cases showed features of fetal vascular malperfusion. Among intra uterine fetal death (IUFD) cases, 2 cases showed features of vascular malperfusion, 7 cases showed low grade acute inflammatory pathology which needs further studies with a greater number of cases to establish relationship with Covid-19 virus. CONCLUSIONS Covid-19 placentas showed increased rates of maternal and fetal vascular malperfusion. These changes may reflect a hypercoagulable state influencing placental pathology and hence an increased antenatal surveillance for women diagnosed with SARS–CoV-2 infection may be warranted. Further studies with control groups are necessary to determine the reproducibility and significance of these initial findings. KEYWORDS Covid-19, Pregnancy, Maternal Vascular Malperfusion, Fetal Vascular Malperfusion.

Background: Chlamydial infection is considered to be one of the important causes of tubal factor infertility. This study will help to explore the relationship between positive Chlamydial infection and tubal damage in infertile women assessed by diagnostic laparoscopy. The results will help to determine whether a policy of routine screening for Chlamydia antibody is justifiable in infertile women to suspect tubal factor so that they can be taken up for laparoscopy earlier.Methods: A prospective study was performed on 158 consecutive patients who underwent laparoscopy as part of infertility evaluation. About 5 mL of venous blood was drawn preoperatively to detect Chlamydia IgG antibody in all the patients by ELISA. The laparoscopic findings were documented and the relationship to Chlamydial antibody evaluated.Results: Of the 158 patients who underwent laparoscopy, 95 patients had evidence of tubal disease as evidenced by unilateral or bilateral tubal block, peritubal adhesions, hydrosalpinx, beading of the tube and unhealthy shaggy appearance. Of the 95 patients with documented tubal disease at laparoscopy, 14 (14.7%) had antibodies to Chlamydia. Of the 63 patients with normal tubes, 12 (19%) had Chlamydial positivity. The difference is not statistically significant. However of the 26 patients who were positive for Chlamydia antibodies 14 patients (53.8%) had abnormal tubes. Out of the 158 patients who underwent laparoscopy 26 patients were positive for Chlamydia. Hence the prevalence in our study is 16.4% (26/158). The sensitivity is 14.7% and the specificity is 81%.Conclusions: This study showed no difference in Chlamydial positivity between infertile women with abnormal tubes and those with normal looking tubes in our population. The absence of Chlamydial antibodies cannot be taken as a marker for normal tubes. Hence screening for chlamydial antibody can neither be used as a screening test for tubal factor infertility nor to decide on the need for laparoscopy in the present population.