Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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We reviewed 284 women with postcoital bleeding (PCB) seen in colposcopy and gynaecology clinics over eight years. 166 women were referred with PCB alone (group 1) and 118 with PCB and abnormal cervical cytology (group 2). The aim was to assess the validity of the Department of Health (DoH) referral guidelines for suspected cancer in women with PCB, to measure the frequency of abnormal findings in these women, and to review the management of PCB with the aim of identifying and addressing deficiencies. No pathology was identified in half of women in group one and in 17% of group two. ⋯ The management of PCB was inconsistent. Neither age nor duration of PCB was a reliable indicator for cervical cancer. A normal smear record must not be regarded as reassuring in a woman with PCB.
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The present study was undertaken at a rural medical institute in India to analyse the trends in maternal mortality due to sepsis and the factors associated with change, if any. During the study period of 20 years, a total of 37,155 women delivered, 192 deaths occurred and forty deaths (20.83%) were due to sepsis and it's sequlae. It was revealed that there is a definite decrease in the proportion of deaths due to sepsis, to 10% in the last five years from 35% in earlier years. ⋯ Septic abortion continues to exist inspite of all the current laws and discussion about the availability of a liberal law, which permits abortion almost on request. Most of the women who had died due to septic abortion were married (65%). Deaths due to septic abortion, are persisting even in married women and it is a matter of concern for health providers, policy makers and governments.
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Rescue in-vitro fertilisation and embryo transfer (IVF-ET) has been used in high response gonadotrophin intrauterine insemination (IUI) cycles to minimise the risks of ovarian hyperstimulation and multiple gestation. Such unplanned IVF treatment increases the cost of treatment. But can this added cost and the risks associated with IVF be justified? We present our experience with this treatment using clinical pregnancy and live birth rates as the primary outcomes. ⋯ The clinical pregnancy and live birth rates were 52% and 48%, respectively. Rescue IVF-ET offers excellent clinical pregnancy and live birth rates in high responders. However, affordability can be an obstacle in the utilization of this treatment option.
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Comparative Study
The value of routine haemoglobin concentration measurement before caesarean section.
Women undergoing caesarean section routinely have a haemoglobin concentration check before delivery. We compared the haemoglobin concentration of 311 women taken at their 32-?34 week antenatal visit with their preoperative level. ⋯ This increase was most marked in the 201 women having emergency procedures, and there was a significant negative correlation between the 32 and 34 weeks level and the net change in haemoglobin concentration (r=-0.366 (P<0.001)). From our results we suggest that in women with an otherwise uncomplicated pregnancy, and a satisfactory haemoglobin concentration at 32-34 weeks, a repeat estimation of the blood count is unnecessary before operative delivery.
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This cross-sectional study of one thousand parturients aims to evaluate the factors, which are associated with pain perception in labour and to identify women who will benefit most from analgesia in labour. The instrument applied was a structured questionnaire incorporating the Box numerical scale (BNS) for pain assessment. Patients who delivered by elective or emergency caesarean section and women who did not give informed consent were excluded from the study. ⋯ Pain scores showed significant correlation with age (r=- 0.087, p<0.01), parity (r=- 0.226, p<0.01), gestational age at delivery (r=- 0.074, p<0.05), onset of labour (rho=0.195, p<0.01), mode of delivery (rho=0.160, p<0.01), booking status (rho=- 0.070, p<0.05) and educational status (rho=0.182, p<0.01). Certain groups of patients would benefit from obstetric analgesia. These patients include, nulliparous patients, young patients, patients who have had labour induced, those with preterm deliveries and those with an assisted vaginal delivery especially if they are well educated.