Background: According to WHO 2009, 60-70% women use one of the method of contraception. 8.8% to 15.4% women use oral contraceptives. Objective of present study was to investigate the effect of oral contraceptives on androgen profile and tear film parameters in females within child bearing age.Methods: Present study involve 100 healthy women between 20-45 years, who presented in family planning clinic. Two groups were made according to the use of oral contraceptive pills. Study group consist of 50 women who were on OCPs (Oral contraception pills) and 50 as control group were not taking any hormonal contraceptives. Serum testosterone and DHEA levels of all subjects was done by Enzyme Immuno Assay on blood samples which were collected during 3th to 7th day of menstrual cycle. Quantitative test for tear secretion was done by Schirmer’s test. Stability of tear film was measured by Tear Breakup time (TBUT). Statistical analysis was done to determine the correlation between use of OCPs and androgen profile and tear film parameters.Results: Present results shows decreased androgen levels in women taking oral contraceptives as compared with age matched women who were not taking oral contraceptives. Tear secretion was significantly reduced in study group as indicated by decreased Schirmer’s test values in study group as compared to control group, the tear film stability was also significantly decreased in women taking oral contraceptives.Conclusions: Present study suggest that androgen profile decrease in women taking oral contraceptives. These results support that use of oral contraceptives may be an important etiological factor in pathogenesis of dry eye disease reproductive age group women.
According to the World Health Organisation (WHO), a caesarean section is a surgical procedure that can save the life of a woman and her baby when undertaken for medical reasons. Thus, the procedure should only be used in complicated pregnancies. However, C-sections have gradually become common in developing countries, and it is already quite common in the developed countries for a long time. A number of obstetric complications such as dystocia, foetal distress, breech births, post-term pregnancy, multiple pregnancy, and pregnancy-induced hypertension are recognized as reasonable motives behind caesarean section deliveries. Approximately 18.5 million caesarean births have been recorded each year globally, accounting for 19.1% of total births, which is beyond the cut-off recommended by the World Health Organization (WHO). In India, the rate of caesarean section delivery is dramatically increased from 3% in 1992–93 to 17% in 2015–16. In terms of regional variations, south Indian states have recorded substantially higher levels of caesarean deliveries in comparison to north India. Despite several studies that have investigated the factors contributing to caesarean section delivery, systematic evidence is still lacking towards understanding the determining factors and formulating effective policies to address the increasing rate of caesarean section deliveries in India. With this backdrop, this study attempts to observe the major indications and prevalence of caesarean section among pregnant women in a tertiary care hospital in India
Background: Pyrexia in pregnancy is major public health problem in India. Pyrexia in pregnancy is associated with resorption of the embryo, foetal deaths and potentially lethal malformations such as central nervous system defects, abdominal-wall defects, and cardiovascular malformations. This study was carried out to analyse clinical profile of women presenting with pyrexia during pregnancy.Methods: After approval by institutional ethical committee the prospective case control study was conducted in the department of obstetrics and gynecology, NSCB Medical College, Jabalpur (M.P.) from 1st June 2012 to 31st October 2013. Total 100 antenatal women with pyrexia taken as cases and 50 antenatal women without pyrexia taken as control were included and analyzed in this study. In women fulfilling inclusion criteria detailed history was taken and documented in proforma. Required investigations were sent to the department of pathology and virology laboratory of Indian Council of Medical Research, Jabalpur. Results were analyzed statistically by using t test and chi square test.Results: On analysis of clinical symptoms pyrexia, cough, malaise, rash, headache, nausea and vomiting, joint pain, anorexia, breathlessness and burning and frequency of micturition were significantly higher in cases as compare to control. Viral pathogens were responsible for most of the cases of pyrexia in pregnancy.Conclusions: Pyrexia in pregnancy is a high-risk situation, early identification and prompt treatment will reduce maternal and perinatal morbidity and mortality associated with pyrexia in pregnancy.
Background: Intrauterine foetal death is an immense emotional burden for everyone concerned specially in the last trimester. Therefore, it is very important to find out, what has happened. Evaluation of clinical and pathological profile of women presenting with intrauterine foetal death has evoked great interest among the obstetricians.Methods: The prospective observational study was conducted in the department of Obstetrics and Gynaecology N.S.C.B. Medical College Jabalpur during 1st June 2012 to 31st October 2013. A total of 155 intrauterine foetal death subjects admitted during this period were evaluated. Clinically and laboratory profile of subjects done. Histomorphology of placenta was performed in each case. Full HPR finding were then correlated with clinical and laboratory findings of subjects. Results: Poor vascularity of villi and fever were significantly associated (p<0.01). Hypertension and Convulsion and fibrinoid necrosis, syncytial knot and placental infarcts were significantly associated (p<0.001) Premature placenta is associated with cytotrophoblastic layer (p<0.01). Conversely post mature placenta is associated with calcification and infarction. (p<0.01). Conclusions: All placentae associated with foetal death have either gross or microscopic abnormalities. Present study is a step towards understanding and extrapolating the already known causes of intrauterine foetal death in the perspective of Jabalpur and its adjoining districts.
Background: Pregnancy Induced hypertension continues to be rampant globally and is associated with high perinatal and maternal mortality and morbidity. It is still one of the most important and intriguing unsolved problems in obstetrics. Hypertensive disorders in pregnancy account for approximately 7 to 15% of all pregnancies and nearly 25% of antenatal ward admissions. The condition complicates about 10% of pregnancies and is responsible for 14% of maternal deaths, 15% of perinatal deaths, and 30% of maternal near misses worldwide. Hypertensive disorders in pregnancy (PIH) are a group of disorders that range from pre-existing chronic hypertension in the index pregnancy to complex multisystem disorders such as preeclampsia, which can lead to complications such as eclampsia, HELLP syndrome, acute renal failure, pulmonary edema, stroke, and left ventricular failure. Though not preventable, early detection and proper intervention can signicantly reduce complications. This is achievable with Prenatal care at all levels. However, there is an unmet need in recognizing and managing PIH and its complications in low and middle-income countries due to pregnancy myths and misconceptions, transportation challenges, low socioeconomic status, and a lack of easy and expert antenatal care requiring a multidisciplinary approach, a lack of accurate prediction methods, and a scarcity of high dependency units (HDU). Early detection of a milder form of disease, corticosteroid administration, and careful timing of delivery can all help improve the outcome. In light of this, we designed and conceived the current study with the goal of studying the maternal and perinatal outcomes of Hypertensive Disorders of Pregnancy at a tertiary care hospital. Furthermore, data from antenatal females with PIH admitted for safe connement were collected and classied into the following categories: GHTN, Preeclampsia, Chronic Hypertension, Chronic Hypertension superimposed with preeclampsia, and eclampsia. Finally, the method of delivery (vaginal/caesarean section) in each category of patients was examined. The study's ndings will assist us in determining the scope of the problem in our area and estimating the fetal and maternal complications associated with it. Methods: All patients beyond 20 weeks of pregnancy with pregnancy induced hypertension admitted in department of Obstetrics and Gynaecology of MGM Medical College over a period of 18 months after approval from Institutional ethical committee was taken into consideration. The objective of the study was to analyze the cases of gestational hypertension, Chronic Hypertension, Chronic Hypertension superimposed with preeclampsia, pre-eclampsia and eclampsia and their maternal outcome in terms of mode of delivery and complications. Perinatal outcome in relation to neonatal complications was also studied. The frequency and percentage for socio-demographic variables, mode of delivery and complications were analyzed. Results: Pregnancy Induced Hypertension cases accounted for 415 cases were enrolled during study period; The most common PIH presentation was pre-eclampsia, followed by severe pre-eclampsia, gestational hypertension, antepartum eclampsia. Maternal morbidity and mortality were observed in 37.6% of the women and 3.6%, respectively in our study. Abruption, wound infection, and eclampsia were the most common complications, accounting for 11%, 9%, and 7.7% of all cases, respectively. 48.2% of babies were shifted to mother side, followed by 41.6% were shifted to SNCU, 7.9% were Intrauterine deaths and least 2.1% were Still birth respectively Conclusions: Though the incidence of pre-eclampsia and eclampsia is on the decline, still it remains the major contributor to poor maternal and fetal outcome. Regular antenatal checkups, early diagnosis, prompt multidisciplinary treatment, optimum timing of delivery reduces the incidence of complications and the maternal mortality. Early referral and management of these cases at centers with advanced neonatal facilities will reduce the perinatal mortality
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