Indication of Induction of Labor-A Hospital Based Study
Dr. Ferdousi Begum, Dr. Nargis Sultana, Dr. Yasmin Ara Begum, Dr. Hachina Akhter, Dr. Mosammat Rehana, Dr. Karishma Sultana, Dr. Sunny Barua, Dr. Nasrin Zannat Sumi
Page Numbers : 527-532
DOI : 10.36348/sijog.2022.v05i11.004
Introduction: Labor induction is the technique that excites childbirth and vaginal delivery. Inducing labour can be built with the pharmaceutical or non-pharmaceutical method. In low-income countries, the rates are generally minor. IOL is not risk-free, and many women find it painful. Aim of the Study: The study aims to investigate the indication of induction of labour. Methods: A Prospective cross-sectional study was carried out in the Department of Obstetrics & Gynecology, Bangabandhu Sheikh Mujib Medical University, Hospital, from January 2008 to June 2008. A total of 50 patients were enrolled in this study following the inclusive criteria. Data were collected using the predesigned semi-structured questionnaire. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. Result: Among the study population (N=50), one-fifth of the mothers’ (10,20.0%) age was under twenty. The majority of mothers were (34,68.0%) between 20-30 years old with a mean age of 25.4 ± 4.32 years. In seventeen patients (17,34.0%) labour induction was given by oxytocin drip followed by ARM, in ten patients labour induction was given by ARM followed by oxytocin drip & in twenty-three patients (23,46.0%) with unfavourable cervix prostaglandin was used and then followed by oxytocin drip and ARM. The total number of induction failures (who needed a caesarian section) was twenty (20,40.0%). Among the total number of caesarian sections, eleven (11,55.0%) were done due to fetal distress, nine (9,45.0%) were done due to abnormal uterine action, one (1,5.0%) was done due to cervical dystocia. Conclusion: Labor induction should be applied to improve birth consequences and when the potential aids outweigh the potential dangers. Researches point out that inducing labour lessens the risk of having a stillbirth, macrosomia and developing high blood pressure as the pregnancy advances.
Original Research Article
Nov. 16, 2022
Correlations between Colposcopy Findings and Histopathological Results from Colposcopy Directed Biopsy in Cervical Pre-Cancerous Lesions
Dr. Sulekha Bhattacharjee, Dr. Khadiza Begum, Dr. Supran Biswas
Page Numbers : 533-537
DOI : 10.36348/sijog.2022.v05i11.005
Introduction: Cervical Intraepithelial Neoplasia is a precancerous condition in which abnormal cells grow on the surface of the cervix. CIN is a symptomless illness that often goes undetected by the naked eye. In most cases, the afflicted cervix appears to be in excellent health. As a result, the illness is detected by chance during cervicological histology or as a result of programs for routine cervical cytology or colposcopy screening. Colposcopy is an extra and valuable technique for identifying cervix anomalies. This study aimed to analyze the correlations between colposcopy findings and histopathological results from colposcopy-directed biopsy in cervical pre-cancerous lesions. Methods: A prospective observational study was conducted at the Department of Gynecology and Obstetrics, Chittagong Medical College Hospital, Chittagong, from September 2014 to February 2015. VIA-positive 72 women fulfilling all inclusion criteria who attended at colposcopy clinic of CMCH were included in the study. Statistical analyses were done by using the Statistical Package for Social Sciences (SPSS) version 16.0 for Windows. The quantitative observations were indicated by frequencies and percentages. Result: In the present study, the majority of the participants were over the age of 30 years, with 43.1% being in the age group of 30-39 years. Another 30.6% were from the age group of 40-49 years, while only 15.2% were from the age group of 20-29 years. Colposcopy findings were normal in 9.7% of the participants. CIN I was observed in the majority of the participants (54.2%), while CIN II and CIN III were observed in 29.2% and 6.94% respectively. According to the colposcopy-directed biopsy results, 5.6% of patients had normal outcomes, 7.7% had inflammations, 45.8% had CIN I, 30.6% had CIN II and 8.3% had CIN III. The correlation was calculated by reporting the number of cases histologically confirmed to the number of cases of colposcopic diagnosis for each lesion group separately. The correlation was 71.8% (28 out of 39) in the CIN I category, 76.2% (16 out of 21) in the CIN II category, and 75% (3 out of 4) in the CIN III category. The sensitivity and specificity of colposcopy were calculated considering a colposcopy-directed biopsy. Colposcopy findings revealed 65 CIN positive cases and 07 CIN negative cases, while biopsy findings revealed 60 positive and 12 negative cases. The sensitivity of colposcopy was 96.7%, specificity was 41.6%, the false positive rate was 58.4% and the false negative rate was 03.3% according to this study. Conclusion: This study demonstrated high accuracy and correlation between colposcopy and histology. The sensitivity of colposcopy was 96.7%, specificity was 41.6%, the false positive rate was 58.4% and the false negative rate was 03.3%. Specificity was lower in this study probably because biopsies were performed in all cases during diagnostic workups.
Original Research Article
Nov. 8, 2022
Fetomaternal Outcome of Patients with Multiple Pregnancy: A Single Centre Experience
Dr. Salma Akhter, Mohibul Islam, Latifa Zaman, SK Tasnuva Alam, Ferdous Ara Banu
Page Numbers : 522-526
DOI : 10.36348/sijog.2022.v05i11.003
Background: Multiple pregnancies are prone to be associated with adverse maternal and perinatal outcome. The incidence of multiple pregnancies has shown a significant increase over the last decades. Aim of the Study: This study aimed to describe the maternal and perinatal outcomes in multiple pregnancies delivered in a tertiary care hospital, Bangladesh. Methods: This was a prospective observational study; 23 patients were enrolled and analyzed. The study conducted with 23 women with twin pregnancies, over 2 year’s months from January 2020 December 2021 in the department of Gynecology and Obstetrics, Chittagong Medical College and Hospital, Chittagong, Bangladesh. Result: Out of 23 cases, 8 patients had intrapartum complications like PPH, mal-presentation, cord prolapse, low-lying placenta, and placental abruption. In this, 4(23.53%) had mal-presentation, and only one had PPH. These intrapartum complications were also categorized according to their chronicity. Mal presentations were seen in 23.53% of DCDA and 33.3% of MCDA with p=0.47. Both were not statistically significant, as shown in Table 4. These twin-specific complications were noted according to their chronicity. Discordant twin was seen in 11.76% of DCDA and 16.67% MCDA. Single IUD in 7.9% of DCDA. The complications and outcomes of the study population; more than 65% of patients needed NICU. In our study, we noted 4 perinatal death caused by intrauterine death, twin-to-twin transfusion syndrome, birth asphyxia, and respiratory distress. Conclusion: Majority of the multiple pregnancy is high risk one. So, all multiple pregnancies need early diagnosis, adequate antenatal, intra-natal and post-partum care to improve the outcome and should have mandatory hospital delivery.
Original Research Article
Nov. 5, 2022
A Cross-Sectional Survey on Prevalence, Interventions, and Outcomes of Unsafe Abortions in GGH, Kadapa
Dr. Bukkittu Ramya, Dr. B.V. Chitra Ravali, Dr. Rabbani Begum
Page Numbers : 517-521
DOI : 10.36348/sijog.2022.v05i11.002
Objective: Unsafe abortions among the various age groups of women due to unintended pregnancy and socio- economic constraints have a deleterious effect on their reproductive and mental health. Hence, review and modification of safe abortion practices are crucial, owing to the rampant availability of over-the-counter MTP kits and D&C by unskilled professionals resulting in Maternal Mortality and Morbidity. This study provides an estimate of the outcomes of unsafe abortions. Methods: WHO  defines unsafe abortion as the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both. The present study is a cross-sectional descriptive analysis of outcomes of unsafe abortions at a tertiary care center, GGH Kadapa. The study data includes all the women admitted to the emergency obstetric unit and treated for unsafe abortions between January 2019 to June 2020. Age group of the selected population is between 15-45. The sample included 342 cases of recent induced abortions. The primary outcome of the study is to emphasise the burden, causes, setting and the morbidity of unsafe abortions. Results: Total number of deliveries that occurred between Jan 2019 to June 2020 is 13787 and the total number of induced abortions during this period was 342. Out of which, 211(61.7%) were unsafe abortions. Among them, 53 women (25.11%) presented with shock. 89 women (42.1%) needed blood transfusions. 8 (3.79%) women went into DIC. One woman had a uterine rupture, and underwent uterine rent repair. Four women had uterine perforation with associated bowel injury. Bowel repair was done in 1 case, and a colostomy was required in 3 cases. Emergency laparotomy was performed in these 5 cases. Conclusion: Unsafe abortions are one of the leading causes of maternal mortality and morbidity in a developing country like India. This is mainly attributed to socio-economic constraints, poor awareness of contraception, and cultural beliefs against sterilization forcing the pregnant women to indulge in unsafe abortion practices. Creating contraception awareness in reproductive age group, strict laws against unsafe abortion practices are to be implemented to reduce the maternal morbidity and mortality due to unsafe abortions.
Original Research Article
Nov. 2, 2022
Analysis of Vesicovaginal Fistulas in Sylhet MAG Osmani Medical Hospital: A Two Years Study
Dr. Umme Sayeeda Bilkish, Dr. Rabeya Begum, Dr. Suraiya Apsara, Dr. Jafrin Yasmin
Page Numbers : 506-516
DOI : 10.36348/sijog.2022.v05i11.001
Background: Vesico-vaginal fistula (VVF) is still a persisting scourge in the developing countries with devastating medical and social consequences. These consequences were studied among patients presenting with vesico- vaginal fistula in Sylhet MAG Osmani Medical College Hospital, Sylhet. Objectives: To analyzethe vesico-vaginal fistula patients during the 2 years period. Materials and Methods: This was a descriptive and cross-sectional study conducted in the Department of Obstetrics and Gynaecology, Sylhet M.A.G. Osmani Medical College Hospital, Sylhet from May 2008 to April 2010 (2 years).Fifty-three hospitalized patients with vesico-vaginal fistula were selected by Inclusion and exclusion criteria, undergoing repair operation irrespective of age. After selection of the patients informed written consent was taken. Each patient was interviewed using the semi-structured questionnaire containing socio- demographic and other relevant information like age, occupation, education of the patient and her husband, age at marriage, age at 1* child birth, monthly income and detailed history of the delivery. Type of fistula and related examination of the fistula was also done and noted. Type of repair of vesico-vaginal fistula, postoperative complications and outcome was recorded in the same manner. Results: The mean age of the patients with vesico-vaginal fistula was 30.5 years (SD± 8.5; range, 18 to 52). Majority (73.6%) were between 21 to 40 years; and 52.8% patients were primipara, 81.1% patients were illiterate and 69.8%patientswere from lower social class. The aetiology of fistula were obstructed labour 49.1%, emergency lower segment caesarean section 37.7%, destructive delivery 11.3% and caesarean hysterectomy 1.9%.The repair operation was done of all patients in this series through vaginal approach. Repair was done first time in 83% and rest had history of failed repair. Postoperative complications were catheter block and urine leakage in 37.7% and urinary tract infection in 11.3% patients. Successful outcome was found in 79.2% cases. Causes of failure were severe scaring 36.5% difficult operation, catheter block and others each constituted 18.2% and large fistula 1.9%. Conclusion: Young primi are the victims of vesico-vaginal fistula, obstetric causes add up to form a major share of the etiology of vesico-vaginal fistula. Proper perinatal management is most important to reduce obs fistula formation.
Original Research Article
Oct. 30, 2022
Study on Association of Serum Magnesium with Preterm Labour
Dr. Dilruba Ferdous, Dr. Mousumi Kader, Dr. Rogina Amin, Dr. Shahana Rahman, Dr. Rabeya Sultana Jolly, Dr. Sayada Fatema khatun, Dr. Rushdana Rahman Toma, Dr. Zinat Ferdousi, Dr. Lutfa Begum Lipi
Page Numbers : 497-505
DOI : 10.36348/sijog.2022.v05i10.012
Background: Magnesium plays an import role in the physiology of parturition. Decrease of Magnesium in plasma may be responsible for a decrease of the same in myometrium and this might have a considerable influence on the preterm labour. A Hypomagnesaemia leads to neuromuscular irritability leading to uterine hyperactivity which leads to cervical dilation. Objective: To find out the association between serum magnesium and preterm level. Methods: This was a cross sectional study, conducted in 100 women in labour, of them 50 were diagnosed case of preterm labour and 50 women were in labour at term attended in Gynaecology and Obstetrics department of Dhaka Medical College, Dhaka, from January 2015 to December 2015.5ml fasting blood sample was collected and was analyzed for serum magnesium using a standard enzymatic method. The mean value of serum magnesium was compared between two groups by student unpaired t-test and serum magnesium level was correlated with BMI, Gravita and gestational age in preterm labour patients by Pearson’s correlation coefficient test. A p-value was considered to be statistically significant at 0.05 at a 95% confidence interval. Results: The mean age was found 28.2±4.5 years in group I and 26.7±4.1 years in group II. The mean age difference was not statistically significant (p>0.05) between two groups. A majority (80.0%) of the patients came from a middle-class family in group I and 29(58.0%) in group II. The mean BMI was found 23.0±3.8 kg/m2 in group I and 26.4±2.4 kg/m2 in group II. The socioeconomic status and BMI were statistically significant (p<0.05) between two groups. The mean serum magnesium was found 1.64±0.13 mg/dl in group I and 2.05±0.11 mg/dl in group II. The mean serum magnesium level was significantly (p<0.05) lesser in group I. Serum magnesium had an area under curve 0.974, which gave a cut-off value < 1.8 mg/dl, with 98.0% sensitivity and 88.0% specificity for prediction of preterm labour. Conclusion: Most of the patients were belonged to age 21-30 years in both groups are not associated. A negligible correlation was found with BMI, gravid, through serum magnesium in preterm labour. Low serum magnesium level was significantly higher in preterm labour.
Original Research Article
Oct. 30, 2022
The Role of “Uterine Artery Doppler” at 11 to 13+6 Weeks for Prediction of Preeclampsia: A Systematic Review
Dr. Shazia Rasul, Dr. Shabnam Tahir, Dr. Miriam Illa
Page Numbers : 488-496
DOI : 10.36348/sijog.2022.v05i10.011
Objective: This systematic review is aimed to review the role of uterine artery Doppler in first trimester of pregnancy along with use of maternal characteristics as a predictor of early and late on set pre-eclampsia (PE). Selection Criteria: The search was limited by selecting; only original articles, prospective & retrospective study designs, role of uterine artery Doppler done at 11 to 14 weeks, done on singleton pregnancy and written in English language were included. Data Collection and Analysis: The data extracted for author name, year of publication, place of study, duration of study, study design, outcomes and study variables including maternal factors, uterine artery Doppler and serum markers. Then detailed analysis of uterine artery Doppler performance as predictor in the form of Area under curve, Sensitivity, Specificity, Positive predictive value, Negative Predictive Value and its relation to preeclampsia, Early PE and Late PE. Results: Following the search strategy of PRISMA, 148 full articles reviewed, and 21 articles were included from 2010 to 2021. Out of 21 articles, 19 articles had “prospective study design” whereas two had “retrospective. Out of 21 researches, 15 assessed early preeclampsia, 4 assessed late preeclampsia, 4 assessed both, however 7 articles studies only preeclampsia as an outcome. The extracted estimate show value of first trimester uterine Doppler as a predictor of early and late preeclampsia. Conclusions: The uterine artery Doppler with maternal characteristics is a valuable, noninvasive tool to be used at 11 to 14 weeks as predictor of preeclampsia in the low resource settings where serum markers cannot be available to general population.