Obs Gyne Review: Journal of Obstetric and Gynecology 2020-09-14T11:52:22+00:00 Dr D Sharad Gedam Open Journal Systems <div id="journalDescription-8" class="journalDescription"> <p><em><strong>ISSN: <a href="" target="_blank" rel="noopener">2455-5444 (Online)</a>, <a href="" target="_blank" rel="noopener">2581-4389 (Print)</a></strong></em></p> <p><em><strong>RNI: MPENG/2017/74037</strong></em></p> </div> The effectiveness of two different doses letrozole in ovulation induction – a comparative study 2020-09-14T07:33:08+00:00 Dr. Susheela Gayam Dr. Bhargavi Sajja Dr. Mary Shashikala Dr. Neelima C Dr. Geeta Rani <p>Introduction: Letrozole is a third-generation selective aromatase inhibitor and an effective agent for ovulation induction. Even though it was used in Clomiphene Citrate failure cases, Clomiphene Citrate resistant women, for Intra-Uterine insemination, and also for mild stimulation for IVF/ICSI cases it has not gained its importance as a first-line drug for ovulation induction.</p> <p>Objective: To study the effectiveness of two different doses of Letrozole in ovulation induction and pregnancy rates and to calculate the proportion of Letrozole resistant and failure cases.</p> <p>Materials and Methods: One year Prospective, observational study was conducted on 120 study participants who were divided into two groups and were given either 2.5 or 5 mg of Letrozole respectively. Serial Ultrasound scans were done from day 10 to assess response to two doses of Letrozole.</p> <p>Results: It was observed that 28 (46.67%) of 60 study participants in group I and 38 (63.33%) of 60 study participants in group II had ovulated.</p> <p>Conclusion: It is observed that there was no significant statistical difference in ovulation rates, Letrozole failure, and resistance rates in both groups. Though the endometrial growth was comparable in both study groups, it was observed that there was better follicular growth in study group II. The study group also showed a statistically significant difference in the pregnancy rates compared to group I. Therefore 5mg dosage of Letrozole could be recommended for ovulation induction.</p> 2020-08-31T00:00:00+00:00 Copyright (c) 2020 Author (s). Published by Siddharth Health Research and Social Welfare Society A Comparison of efficacy of I/V Iron V/S Oral Iron for management of iron deficiency anemia in pregnant women in a tertiary care center 2020-09-14T07:36:32+00:00 Dr. Sakshi Kalra Dr. J. K Goel Dr. Shanti Sah Dr. Shashibala Arya <p>Introduction: WHO defines anemia in pregnant women as hemoglobin level &lt;11gm/dL and a hematocrit of &lt;0.33. The number of patients with iron deficiency anemia is&gt;2 billion which accounts for 30% of the world’s population. The incidence of iron deficiency anemia in India is around 50%.</p> <p>Material and Methods: A study was performed in the Department of Obstetrics and Gynecology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India on 100 antenatal patients with nutritional anemia gestational age of 14-36 weeks. Group A was treated with intravenous iron sucrose and group B was treated with oral iron sulfate. Pretreatment hemoglobin, S. ferritin levels, and General Blood Picture were recorded. During the course of treatment, any adverse reactions with either formulation, if occurred were recorded. Patients were followed up after 4 weeks with repeat hemoglobin and S. ferritin level.</p> <p>Results: The mean improvement of hemoglobin among I/V and Oral iron following treatment was 1.68±0.33 gm/dl and 0.96± 0.31 gm/dl respectively which was statistically significant. The improvement in iron stores was also observed more in the I/V group with a rise of S. ferritin of 27.21±9.5 ng/ml against a rise of 3.72± 0.7 ng/ml in the oral group. This was statistically significant with a P-value of 0.000 in the I/V group. No major adverse reactions were seen in both groups.</p> <p>Conclusion: Intravenous iron sucrose is safe and more effective than oral iron therapy in the treatment of iron deficiency anemia and to restore iron stores in pregnant women.</p> 2020-08-31T00:00:00+00:00 Copyright (c) 2020 Author (s). Published by Siddharth Health Research and Social Welfare Society The prevalence of Vitamin D deficiency in pregnancy and neonatal outcomes 2020-09-14T09:47:09+00:00 Dr. Susheela Gayam Dr. Summaya Fatima Dr. Neelima C Dr. Geeta Rani <p>Introduction: Vitamin D is an essential fat-soluble vitamin and has multiple functions. It affects calcium metabolism, modulates the immune system, cell proliferation, and differentiation.</p> <p>Objective: To study the prevalence of vitamin D deficiency in pregnant women and neonatal outcome in a tertiary care hospital, to study the association between maternal vitamin D and medical disorders, and to correlate maternal vitamin D deficiency with neonatal vitamin D levels and neonatal outcomes.</p> <p>Materials and Methods: This cross-sectional and observational study was conducted over a period of one year on 355 antenatal women admitted for safe confinement. 4 ML of whole blood was collected from median ante-cubital fossa and vitamin D levels were assessed using ELFA [Enzyme Linked Fluorescent Assay] following delivery, and 2ml of cord blood was also collected and sent for Vitamin D levels. R</p> <p>esults: Out of the total study population, 12.96% (46) had adequate levels of vitamin D, the majority - 74.65% (265) had insufficient vitamin D levels, and 12.39% (44) had severe vitamin D deficiency. The overall deficiency among neonates was 95.22%. No significant association was found between vitamin D deficiency and maternal complications, except for the mode of delivery which was statistically significant with a P-value of 0.04.</p> <p>Conclusion: This study reaffirms that vitamin D deficiency is on the increase and therefore needs intervention by biochemical screening and corrective measures during pregnancy.</p> 2020-08-31T00:00:00+00:00 Copyright (c) 2020 Author (s). Published by Siddharth Health Research and Social Welfare Society Postoperative wound infection after obstetrics and gynaecology surgeries: A study from the tribal tertiary healthcare centre 2020-09-14T09:53:51+00:00 Dr. Monika Parmar Dr. Mahendra Damor <p>Aims and Objectives: the study was conducted to find out the incidence of postoperative wound infection among obstetric and gynaecological surgeries in the tribal area of Rajasthan region with the objective to identify various preventable risk factors and common responsible pathogen.</p> <p>Material and methods: It was a prospective study conducted in the department of Gynaecology in Government Medical College and Hospital, Dungarpur during the period of six months from August 2019 to January 2020.</p> <p>Results: Out of 300 surgeries performed, 210 surgeries were obstetrics and 90 surgeries were gynaecological. The mean age of obstetrics cases was 26.89±2.5 years and of gynaecological cases was 48.22±4.8 years. Frequency of wound infection in obstetrics cases was 5.23% (11 cases) and was 11.11% (10 cases) in gynaecological surgeries with a total frequency of 7% (21 cases). Mean postoperative day of wound infection was 9.81±5.6, mean postoperative hospital stay was 8.10±5.6 days and the mean duration of surgery was 1.29±0.45 hours. Body mass index (BMI) was &gt;25 (obese) in 61.90% of infected cases. 15 patients (10.41%) out of 144 patients who did not receive antibiotic prophylaxis, developed wound infection. On culture, Escherichia Coli (E.coli) was found to be the most common responsible pathogen (38.09%) followed by Klebsiella species and Staphylococcus aureus (19.04%).</p> <p>Conclusion: Early identification of various risk factors for postoperative wound infection in obstetric and gynaecological surgeries is essential to prevent further morbidities.</p> 2020-08-31T00:00:00+00:00 Copyright (c) 2020 Author (s). Published by Siddharth Health Research and Social Welfare Society Preoperative dexamethasone and intraperitoneal bupivacaine for postoperative pain relief 2020-09-14T11:52:22+00:00 Dr. Susheela Gayam Dr. Naduvinakeri K. Dr. Meera Rajagopal Dr. Neelima C. <p>Introduction: Remarkable advancement in managing post-operative pain is made using various analgesics. Dexamethasone is a potent anti-inflammatory, analgesic, and anti-emetic agent and readily available, easy to administer, and a safe adjunct for postoperative analgesia. The intraperitoneal use of local anesthetics is known to improve postoperative pain. The present study is aimed to assess the effectiveness of preoperative dexamethasone combined with intra-peritoneal bupivacaine for postoperative pain relief.</p> <p>Objective: To assess the effectiveness of preoperative Dexamethasone combined with intra-peritoneal Bupivacaine for postoperative pain relief following surgery.</p> <p>Material and Methods: A prospective, randomized controlled study was done over a period of one year on 172 women scheduled for elective gynecological surgeries. The study group received Dexamethasone 8mg IV, 5 minutes prior to induction of anesthesia or before surgical incision, and intra-operatively 30ml of 0.25% Bupivacaine intraperitoneally under aseptic precautions. The control group received standard anesthesia as per the routine hospital protocol. Postoperatively patients monitored for vitals, pain assessment using Visual Analogue Score. The severity of postoperative nausea and vomiting (PONV) was evaluated. After a 24-hour assessment period, patients were asked to make an overall rating of satisfaction with post-operative pain relief on a verbal response (VReS).</p> <p>Results: It was noted that the mean consumption of analgesic doses was significantly high in group B compared to group A (3.01±0.52 vs 1.46±0.83; p&lt;0.001).The mean VRes scores in group A were significantly high compared to group B (2.95±1.01 vs 0.20±0.51; p&lt;0.001).</p> <p>Conclusion: Dexamethasone combined with intra-peritoneal Bupivacaine is highly effective in reducing postoperative pain along with PONV.</p> 2020-08-31T00:00:00+00:00 Copyright (c) 2020 Author (s). Published by Siddharth Health Research and Social Welfare Society