Department Of Obstetrics Research Articles

Effect of methanol stem bark extract of Ochna schweinfurthiana (Ezeata) on liver enzymes in Wistar rats

1 Department of Obstetrics and Gynaecology, Faculty of Clinical Medicine, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Amaku, Awka. Anambra State. Nigeria. 2 Department of Physiology, Faculty of Basic Medical Sciences, Chukwuemeka Odumegwu Ojukwu University, Uli campus. Anambra State. Nigeria. 3 Department of General Medicine, Faculty of Clinical Medicine, Royal Bournemouth Hospital (University Hospital Dorset NHS Foundation Trust) Bournemouth, England, BH7 7DW United Kingdom. 4 Department of Gastroenterology, Faculty of Clinical Medicine, Royal Bournemouth Hospital (University Hospital Dorset NHS Foundation Trust) Bournemouth, England, BH7 7DW United Kingdom. 5 Department of Obstetrics and Gynaecology, Faculty of Clinical Medicine, Abia StateUniversity Teaching Hospital, Aba. Abia State. Nigeria.

Can EBP50 and Merlin be used as diagnostic and prognostic markers for uterine smooth muscle tumors?

Uterine smooth muscle tumors are common neoplasms of smooth muscle in the uterus. They range from benign leiomyomas and their variants to malignant leiomyosarcomas. Although there are many subtypes of leiomyoma, mitotically active leiomyoma and leiomyoma with bizarre nuclei are sometimes difficult to differentiate from leiomyosarcoma. Our aim in this study was to investigate whether EBP50 and Merlin expression can be used in the differential diagnosis of uterine smooth muscle tumors and to determine their prognostic significance. Our study analyzed 80 cases diagnosed with uterine smooth muscle tumors from the Pathology Department archive of Dicle University Faculty of Medicine between 2012 and 2023. Primary antibodies EBP50 and Merlin were used in the immunohistochemical study. Information regarding patient age, treatment, and clinical follow-up was obtained from Dicle University Department of Obstetrics and Gynecology and Dicle University Department of Medical Oncology. Our study revealed that EBP50 expression was significantly higher in the leiomyosarcoma and STUMP groups, while Merlin expression was significantly higher in only the leiomyosarcoma group. Prognostic parameters were not found to be associated with EBP50 and Merlin expression levels. EBP50 and Merlin expression levels have not been previously studied in uterine smooth muscle tumors. Our study suggests that high expression of EBP50 in STUMP and leiomyosarcoma, as well as Merlin in leiomyosarcoma, may be helpful in the differential diagnosis of uterine smooth muscle tumors.

Innovative continuum of care to promote exclusive breast feeding in Pakistan: protocol of a pilot randomised controlled trial

BackgroundBreastmilk being the ideal nutrition from birth to 2 years and beyond has many health benefits for both newborn and mothers. This study will assess the feasibility and acceptability of...

Direct embryonic biopsy with transcervical embryoscopy is an effective method for karyotyping and morphology assessment in miscarriages.

The main purpose of this study is to compare the validity of transcervical embryoscopy method with standard uterine evacuation method in detecting more accurate karyotypes in miscarriages below tenth week of pregnancy. Additionally, the frequency and distribution of fetal morphological abnormality were evaluated. A prospective study was carried out at the Gazi University Faculty of Medicine, Department of Obstetrics and Gynecology. Patients with missed abortions between sixth and tenth gestational weeks were included in the study group, and fetal morphological examination and direct embryonic biopsy were performed by transcervical embryoscopy. The control group consisted of patients who experienced miscarriage and genetic material obtained from routine uterine evacuation between February and October 2023. A total of 60 patients in the study group and 189 patients in the control group were evaluated. The median ages, previous miscarriage numbers, median gravida numbers, and median gestational weeks were comparable between groups. Chromosomal abnormality was detected in 24 (42.8%) and 52 embryos (29.9%) in the study and control groups, respectively (p = 0.004). Culture failure rates were 6.6% (n = 4) and 7.9% (n = 15) in the study and control groups, respectively. In the study group, 12 embryos had a morphological abnormality in which 6 of them had normal karyotype. Direct embryonic biopsy with transcervical embryoscopy is an effective method to exclude maternal decidual cell contamination and placental mosaicism in miscarriages for karyotype analysis. In addition, detecting anomalies in morphology might contribute our understanding in the process of miscarriages which arises independent from structural/numerical chromosomal abnormalities.

Anatomical variations and embryological basis of arch of aorta and aortic valve.

Variations in the arch of the aorta and aortic valves among fetal, cadaveric, and post-mortem specimens present a spectrum of anatomical configurations, posing challenges in establishing a standard norm. While some variations hold surgical significance, many bear little functional consequence but provide insights into embryological origins. The aortic arch exhibits diverse branching patterns, including common trunks and different orders, relevant for endovascular surgeries. Meanwhile, malformations in the aortic valve, affecting the aorta, may lead to ischemia and cerebral infarction, warranting understanding of coexisting arch and valve anomalies to predict complications like aortic dissection. Studies in the Indian population mirror global variations, underscoring the need to explore embryological, clinical, and surgical implications for safer vascular surgeries involving the aortic arch and valves. The study's objectives included examining branching patterns, diameters, and distances between arch branches and exploring aortic valve variations. Employing a cross-sectional design, the study was conducted across Anatomy, Forensic Medicine, and Obstetrics and Gynecology departments. A sample of 100, comprising cadavers, fetuses, and postmortem specimens, were gathered. Specimens ranged from 14weeks of intrauterine life to 85years, with intact thoracic cages as inclusion criteria. Methodology involved dissection, specimen fixation, and macroscopic examination for variations and morphological parameters. Results showed aortic diameter increase with age, with significant gender differences. A statistically significant association between arch variations and anomalous valves was observed, suggesting mutual predictability. Individuals with valve anomalies should undergo comprehensive cardiology evaluation to avert complications like aortic dissection during endovascular surgeries. While atheromatous plaques were prevalent in younger groups, their frequency rose with age, necessitating vigilant vascular monitoring. Careful handling during surgeries is paramount, given potential adverse outcomes resulting from variations. Overall, the study underscores the importance of comprehensive anatomical understanding in clinical contexts, guiding effective management strategies and ensuring patient safety in vascular surgeries.

Understanding the burden of teenage pregnancy: A five-year analysis at a tertiary care center of northern Karnataka in India

: The present study was planned to comprehensively investigate the epidemiological aspects and clinical feto-maternal outcomes associated with teenage pregnancy, to provide a holistic understanding of teenage pregnancy and the possible solutions. : This is retrospective record-based research conducted over a five-year period, spanning from January 2018 to December 2022, in the department of Obstetrics and Gynaecology of a tertiary care centre in northern part of Karnataka, India. The teenage pregnancy was considered as all pregnancies that occurred in women aged between 13 to 19 years who visited the institute for delivery during the study period. A comprehensive analysis was conducted, encompassing various facets of their antenatal experiences, delivery methods, postpartum complications, as well as the well-being of the new-borns. : A total of deliveries 52,715 deliveries had been recorded in our institute during the study period. Among these deliveries, 1,754 were among teenagers, resulting in a prevalence rate of 3.33%. Nearly one-fifth (19.16%) of teenage mothers were short stature whereas only 7.02% of adult mothers were short stature. The relatively higher proportion of teenage mothers were underweight. Maternal and fetal complication were comparatively higher among teenage mothers whereas caesarean sections were relatively more among adult mothers. : The present study emphasizes the importance of targeted healthcare interventions, including improved prenatal care, nutritional support, and education for teenage mothers, to mitigate these risks and improve the overall health and well-being of both mothers and their infants.

A comparative study on knowledge, awareness and perception of contraception among rural and urban population in Punjab

In developing countries like India, a lack of awareness about contraceptive methods often leads to misconceptions, limited choices, and improper family planning. This knowledge gap not only disrupts maternal and child health complications but also disrupts the economy of society and the nation. Therefore, the purpose of this study was to investigate the knowledge, awareness and perception of contraception among the rural and urban population in Punjab.This observational study conducted in the Department of Obstetrics and Gynecology at a tertiary health care centre, in Punjab, India. A total of 500 women were evaluated with the help of a pre-designed questionnaire to address knowledge, awareness, and perception of contraception among the rural and urban population in Punjab. The statistical analysis was performed by using SPSS Windows, version 28. In the present study, a total of 492 participants were included, of whom 387 were from rural areas and 105 were from urban areas. This study revealed, 100% of participants were aware of contraception. In terms of the source of information, social circles were identified as the primary channel (46.34%), followed by the media (33.94%), health workers (16.87%), and educational institutes (2.85%).This study highlights contraceptive methods, including condoms, oral contraceptives, and intrauterine devices (IUDs), as primary choices. Therefore, it's important to bridge the gap between awareness and action. Hence, this study, advocate the awareness program on interventions to ensure everyone can access effective family planning resources without barriers.

The role of color doppler in high risk pregnancies: A prospective comparative study

Pregnancy can be considered as the most beautiful period of a woman’s life. The recent medical advances are helpful in taking very good care of the female throughout her pregnancy. The pregnancy is constantly observed by clinical examination, laboratory investigations, and radiographic examinations at specific intervals throughout its course.To study the role of doppler ultrasound in high-risk pregnancies.This is a prospective comparative study was conducted in department of Obstetrics and Gynaecology at Government medical college, Nagpur. The study period was 12 months. 232 patients were included in this study.In our study, 2 patients had Chronic hypertension, 2 patients had GDM, 1 patient had Gestational hypertension, 3 patients had Anaemia, 6 patients had Heart Disease, 5 patients had HIV positive,15 patients had Hypothyroidism, 2 patients had Increased BP, 1 patient had Overt DM,6 patients had Pre-eclampsia,1 patient had previous abortion, 4 patients had Rh negative, 5 patients had Sickle Cell Disease(SS) and 15 patients had Sickle Cell trait(AS). Distribution of normal doppler changes in cases according to high risk factor was statistically significant (p<0.0001).In our study, NICU Admission with doppler changes was statistically significant and Association of Baby weight in cases according to doppler changes in uterine artery and Baby weight in cases according to doppler changes in umbilical artery was not statistically significant.

Could the YEARS algorithm be applied to evaluate suspected pulmonary embolism in hospitalized women after cesarean section?

To evaluate the effectiveness of the YEARS algorithm for excluding pulmonary embolism (PE) in hospitalized women after cesarean section. This retrospective study included postpartum women who gave birth by cesarean section and received computed tomography pulmonary angiography (CTPA) because of suspected PE in the obstetric department between 2015 and 2021. We used the YEARS algorithm in these women retrospectively and assessed its performance to evaluate whether the algorithm could be reliably applied in such cases. In all, 225 women were included in the study, of whom 29 (12.9%) women were positive for PE according to the results of CTPA. Upon retrospective application of the YEARS algorithm, 188 (83.6%) women had no YEARS items, while 37 (16.4%) women had YEARS items. Combining the results with D-dimer levels revealed that only 12 (5.3%) women did not need to undergo CTPA, and none showed PE. The YEARS algorithm could be applied to exclude PE in hospitalized women in the early post-cesarean period. However, the specificity of the YEARS algorithm was very low, and the D-dimer cut-off for ruling out PE in women after early cesarean section should be further studied and optimized.

Sonographic and histopathological findings endometrium among perimenopausal women with abnormal uterine bleeding- A cross sectional study in north Kerala

: AUB makes a perimenopausal woman to seek medical care. This study evaluated and correlated the endometrial thickness obtained by ultrasonography and histopathological findings of endometrium in perimenopausal women with AUB.A hospital based observational cross-sectional study was conducted in Obstetrics and Gynaecology Department, Baby Memorial Hospital, Calicut for a period of 18 months. Histo-pathologic evaluation of endometrial tissue was done and was correlated with endometrial thickness.: The average age of women enrolled was 47.88 years with standard deviation of 3.729. The average endometrial thickness was 12.40mm. Endometrial hyperplasia without atypia was the leading histopathological finding obtained after analysis of endometrium (21.5%). This study shows that there is a significant relationship between histopathology findings of endometrium and age of participant and between endometrial thickness and menorrhagia. There was no relationship between histopathology findings and endometrial thickness. Perimenopausal AUB should be evaluated in a systematic manner, so that endometrial hyperplasia, carcinoma endometrium could be diagnosed in a very early stage and prompt treatment be given at right time reducing morbidity improving the quality of life.

Proportion of Newly Detected Hypothyroidism among the Diabetic and Nondiabetic Pregnant Ladies and Correlation of Different Parameters with Thyroid Stimulatory Hormone in Pregnancy Attending a Tertiary Care Hospital

ABSTRACT Background: Subclinical hypothyroidism and gestational diabetes are the two most common endocrinopathy encountered in daily clinical practice. Many literature showed a higher frequency of hypothyroidism in the persons with diabetes but others did not find it. Objectives: The study was intended to compare the proportion of newly detected hypothyroidism in persons with diabetes and without diabetes in pregnancy (DIP). Materials and Methods: This cross-sectional, observational study enrolled 175 pregnant women by convenient sampling from the Department of Obstetrics and Gynecology, BIRDEM General Hospital, with or without diabetes after IRB clearance. According to the study protocol, Thyroid function test (TFT) and oral glucose tolerance test were done in the participants. Thyroid stimulatory hormone (TSH), free thyroxin, and antithyroid antibodies were tested using the chemiluminescent technique by the ADVIA centaur, Siemens. Plasma glucose was analyzed by Advia-1800, SIEMENS, USA by glucose oxidase method. Data were analyzed by SPSS version 25. Nonparametric tests were chosen for statistical analysis. Results: The median maternal age was 30 years, and half of the participants had a family history of diabetes mellitus (DM). Hundred patients had diabetes either gestational DM or DIP or preexisting diabetes. Among the persons with diabetes, 34% had hypothyroidism, and in euglycemic patients, 29.3% had hypothyroidism. There was no statistically significant (P = 0.785) difference in the median values of TSH across the glycemic status among the hypothyroid subjects. TSH had a positive correlation with thyroid peroxidase antibody (P = 0.174) within the hypothyroid patients. In the study subjects, TSH was inversely correlated with hemoglobin (P < 0.001). Conclusions: There is no statistically significant concordance in diagnosing hypothyroidism in pregnancy between the persons with diabetes and without diabetes.

Improving Environmental Sustainability of Operating Theatres: A Systematic Review of Staff Attitudes, Barriers, and Enablers.

To understand views of staff in relation to attitudes, enablers, and barriers to implementation of environmentally sustainable surgery in operating theatres. This will ultimately help in the goal of successfully implementing more sustainable theatres. Global healthcare sectors are responsible for 4.4% of greenhouse gas emissions. Surgical operating theatres are resource intensive areas and improvements will be important to meet Net-Zero carbon emissions within healthcare. Three databases were searched (Web of Science, Ovid and PubMed), last check January 2024. We included original manuscripts evaluating staff views regarding sustainable operating theatres. The Mixed Methods Appraisal Tool was used for quality appraisal and data analysed using thematic synthesis. 2933 articles were screened and 14 fulfilled inclusion criteria, using qualitative (1), quantitative (2), and mixed methods (11). Studies were undertaken in a variety of clinical (Department of Anaesthesia, Surgery, Otolaryngology, Obstetrics & Gynaecology and Ophthalmology) and geographical settings (Australia, Canada, France, Germany, New Zealand, USA, UK & Ireland,). Across studies there was a lack of evidence exploring enablers to implementation, but barriers mainly related to the following themes: education and awareness, leadership, resistance to change, facilities and equipment, time, and incentive. This systematic review identified attitudes and barriers perceived by clinicians towards improving environmental sustainability within operating theatres, which may inform future strategy towards sustainable surgery. Most studies used a survey-design, whereas use of interviews may provide deeper insights. Future work should be extended to wider stakeholders influencing operating theatres. Additionally, implementation studies should be carried out to examine whether barriers do change in practice. This systematic review identified attitudes and barriers perceived by clinicians towards improving environmental sustainability within operating theatres, which may inform future strategy towards sustainable surgery. Most studies used a survey-design, whereas use of interviews may provide deeper insights. Future work should be extended to wider stakeholders influencing operating theatres. Additionally, implementation studies should be carried out to examine whether barriers do change in practice.

Amniotic Fluid Volume: An Important Deciding Factor for Pregnancy Continuation in Preterm Premature Rupture of Membranes

Abstract Aims and Objectives: To find out various risk factors affecting fetomaternal outcomes in preterm premature rupture of membranes (PPROM). Materials and Methods: A prospective study after approval from the ethical committee was conducted at VMMC and Safdarjung Hospital, New Delhi, Department of Obstetrics and Gynaecology from December 2020 to May 2022 in which 100 pregnant women with preterm premature rupture of membrane between 32 and 36 weeks of gestation were enrolled. Patients were followed with Total leucocyte count (TLC), urine R/M, urine C/S, high vaginal swab C/S, and C-reactive protein along with routine antenatal care investigations. Intravenous antibiotics were given to all patients for 48 h followed by oral antibiotics for 5 days. All patients were on follow-up and managed conservatively and induction of labor was done at 37 weeks or earlier in case of fetal distress and presence of signs and symptoms of chorioamnionitis. Both mother and baby were followed till 7 days after delivery. Results: In the present study, we observed the following risk factors that had adverse effects on fetomaternal outcomes in PPROM patients. The association of oligohydramnios (amniotic fluid index [AFI] <5) with neonatal sepsis (P = 0.025) and neonatal death (P = 0.025) was found to be significant. Vaginal infection was found to be significantly associated with birth asphyxia (P = 0.024), APGAR <7 at 1 min (P = 0.015), neonatal intensive care unit (NICU) admission (P = 0.009), and postpartum hemorrhage (PPH) (P = 0.002). The association of urinary tract infection (UTI) with neonatal sepsis (P = 0.01), birth asphyxia (P = 0.005), APGAR <7 at 1 min (P = 0.001), NICU admission (P = 0.002), neonatal death (P = 0.01), and PPH (P = 0.0004) was found to be significant. We also observed that the duration from membrane rupture to delivery had no adverse effect on fetomaternal outcome, may be as we had given antibiotics to all patients from the time of admission. Conclusions: The conclusion from the present study was that oligohydramnios (AFI <5) is a significant risk factor for adverse neonatal outcomes in PPROM along with vaginal infections and UTIs. Hence, amniotic fluid volume should also be considered as an important deciding factor for pregnancy continuation in PPROM.

Clinical Manifestations of Malignant Struma Ovarii: A Retrospective Case Series in a Tertiary Hospital in Korea.

Malignant struma ovarii (MSO) is a very rare disease in which thyroid cancer originates from the ovary. Because it is rare for endocrinologists to encounter patients with MSO, endocrinologists may have a limited understanding of the disease. Therefore, we analyzed and introduced its incidence and clinical course in a tertiary hospital in Korea. We retrospectively investigated the clinical data of 170 patients who underwent surgery for struma ovarii at the Department of Obstetrics and Gynecology of Samsung Medical Center from 1994 to May 2023. Among 170 patients with struma ovarii, 15 (8.8%) were diagnosed with MSO. The median age of patients with MSO was 48 years (range, 30 to 74), and the median tumor size was 3.3 cm (range, 0.5 to 11.0). Papillary thyroid carcinoma (46.7%) was the most common subtypes followed by follicular thyroid carcinoma (26.7%). All patients were diagnosed after surgery, with no predictions from preoperative imaging. The surgical extent of gynecological surgery was variable. Four patients (26.7%) underwent thyroidectomy for thyroid cancer, while one underwent total thyroidectomy and radioactive iodine therapy for MSO with peritoneal metastasis. Except for one patient who underwent hemithyroidectomy, thyroid stimulating hormone suppression therapy was performed in four patients. Only 53% of MSO patients were consulted by an endocrinologist. With a median follow-up period of 33 months (range, 4 to 156), 11 patients remained disease-free, one experienced progression with peritoneal seeding, and the remaining one was in treatment. There have been no recurrences or deaths due to MSO. An endocrinologist should be involved in establishing a therapeutic plan for MSO, for which the overall prognosis is generally favorable.

Efficacy of Doxylamine and Pyridoxine during Pregnancy Induced Nausea and Vomiting

Introduction: Nausea and vomiting in pregnancy (NVP) is the most common medical condition of pregnancy causes a significant clinical, psychological and economic burden. Therefore, it is very important to treat this condition appropriately and effectively. The combination of Doxylamine and Pyridoxine is recommended as first-line therapy for nausea and vomiting in pregnancy. Objectives: To observe the therapeutic efficacy of combined Doxylamine and Pyridoxine for treatment of nausea and vomiting in pregnancy. Materials and Methods: An observational study was conducted on patients with nausea and vomiting in pregnancy attended the Model Family planning clinic in the Department of Obstetrics and Gynaecology, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from January 2019 to December 2019. A total 90 patients with clinically meaningful nausea vomiting (Pregnancy-Unique Quantification of Emesis [PUQE] score > 6) were selected and given 2-4 tablets each containing combined Doxylamine succinate 10 mg and Pyridoxine hydrochloride 10 mg based on a pre-specified titration protocol response to symptoms by respective physician and PUQE score was recorded in all participants before initiation of treatment and at 8th day and 15th day of treatment. In course of follow up period 7 patients were dropped out and finally 83 patients were analyzed in this study. Result: The mean PUQE score was decreased from 10.27 ± 1.76 to 7.94 ± 1.75 at 8th day and to 5.35 ± 1.47 at 15th day of treatment was significant (p<0.001). The percentage reduction of PUQE score was 23.14% at 8th day and 46.91% at 15th day of treatment. The difference was significant (p<0.001). Conclusion: Combined Doxylamine-Pyridoxine is effective and well tolerated in the treatment of nausea and vomiting in pregnancy (NVP). Medicine Today 2023 Vol.36 (1): 26-30

Clinicopathological Evaluation of Thyroid Dysfunction in Women with Abnormal Uterine Bleeding

Introduction: Abnormal uterine bleeding describes any variation from normal bleeding patterns in nonpregnant, reproductive-aged women beyond menarche lasting for at least 6 months. Regular cyclic menstruation results the choreographed relationship between the endometrium and its regulating factors. Any type of disturbance between the regulatory mechanism of pituitary ovarian axis or pelvic diseases results in abnormal uterine bleeding. Thyroid hormones play a key role in the menstrual and reproductive function of women. It is recognized universally that menstrual disturbances may accompany clinical alterations in thyroid function. Objectives: To evaluate the thyroid dysfunction in patients with abnormal uterine bleeding. Materials and Methods: This cross sectional study was conducted in Department of obstetrics & gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from April 2023 to December 2023. Women with abnormal uterine bleeding were included in the study. Sample was selected by purposive sampling. Sample size was 100. Detail demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigation were done meticulously. Data was collected by using a semi-structured questionnaire. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage. Result was presented in the form of tables, pie chart, graphs, bar diagrams, histogram & charts etc. Results: In this study, the maximum numbers of cases (43.0%) were between 26-35 years age group. Mean age was 29.57 ± 8.27 years. Large numbers of respondents came from urban area (58%). On evaluation of types & causes of AUB, maximum patient belongs to AUB-L (leiomyoma) group (53%) followed by AUB-A (adenomyosis) (28%); AUB-P (polyp) (8%); AUB-O (ovulatory) (9%) and AUB-M (malignancy) (2%). Present study showed that prevalence of thyroid disorders is 26% in AUB patients. The prevalence of Hypothyroidism was 18% and Hyperthyroidism was 8%. Thyroid dysfunction is associated with menstrual abnormalities in females of all age groups. Conclusion: Abnormal uterine bleeding has a strong association with thyroid disorders. The most common type of disorder is subclinical hypothyroidism. Thus, all patient of AUB must be evaluated for thyroid dysfunction. Medicine Today 2023 Vol.36 (1): 1-6

Management of Gestational Diabetes Mellitus: Knowledge, Attitudes, and Practices of Obstetric Doctors in Benghazi, Libya

Abstract Introduction Gestational diabetes mellitus (GDM) adversely affects the mother and fetus. Its diagnosis and management are of great importance to prevent complications. Mothers with GDM are at great risk of developing type 2 diabetes, and metabolic changes can persist for 3 years postdelivery. We assessed the knowledge and practice of obstetricians working at Benghazi Medical Centre (BMC) regarding gestational diabetes. Materials and Methods A cross-sectional descriptive study was conducted at the obstetric department of BMC; we included all postgraduate doctors in July 2021 in the study. The questionnaire included demographic data and questions related to knowledge regarding the definition of GDM, diagnosis, and complications to the mother and fetus. It also included practices toward GDM, including screening, management, follow-up, and postpartum screening for diabetes. Results The total number of doctors who agreed to participate was 102, and the response rate was 72.9%. The mean age of the participants was 35.4 ± 7.2 years; most of the studied group were females 97 (95.1%), 76 (74.5%) were senior house officers, 16 (15.7%) were mid-grades, and 10 (9.8%) were seniors. Most working obstetricians, 76 (74.5%), had less than 10 years of experience. One hundred (98%) participants heard about GDM, and only 39 (38.2%) correctly defined GDM. Regarding the threshold for fasting glucose to diagnose GDM, only 11 (10.8%) gave a right answer of 92 mg/dL. Most participants had a good knowledge of GDM risk factors and complications. Regarding follow-up, only 35 (34.3%) participants provided the correct answer, and only 27 (26.5%) mentioned insulin as the medical treatment of choice. Conclusion Although most of our studied group had contact with GDM patients, most needed basic knowledge regarding definition, diagnosis, and screening. Different opinions regarding diagnostic thresholds and management practices were observed. We recommended the establishment of a gestational diabetes clinic with the cooperation of endocrinologists and obstetricians, as well as local guidelines.

COMPARISON SEROPREVALENCE OF TOXOPLASMA GONDII, RUBELLA, AND CYTOMEGALOVIRUS IN MUŞ PROVINCE BEFORE AND DURING COVID-19

COMPARISON SEROPREVALENCE OF TOXOPLASMA GONDII, RUBELLA, AND CYTOMEGALOVIRUS IN MUŞ PROVINCE BEFORE AND DURING COVID-19

Comparison of Maternal and Neonatal Complications in Women with and without Gestational Diabetes Mellitus

Background: Gestational Diabetes Mellitus (GDM) is a common pregnancy-related metabolic disorder associated with adverse maternal and neonatal outcomes. Gestational Diabetes Mellitus is characterized by glucose intolerance that develops during pregnancy. It affects approximately 7% of all pregnancies and has been linked to an increased risk of maternal and neonatal complications. Objective: The study was aimed to provide a comprehensive comparison of maternal and neonatal complications in women with and without GDM involving a thorough examination of medical records and clinical data to identify patterns and associations between GDM and various complications. Methods: A retrospective cohort study was conducted, including pregnant women with and without GDM who received prenatal care and underwent hospital delivery at the Department of Obstetrics and Gynecology, Enam Medical College and Hospital, Dhaka, Bangladesh from June 2022 to June 2023. Clinical data, including maternal age, gestational age at diagnosis, parity, and antenatal care were collected. Pregnancy outcomes, such as maternal complications, and live birth complications were also assessed. Result: A total of 60 pregnant women were included in the analysis, 30 were diagnosed with GDM and 30 without GDM. Analysis of pregnancy outcomes revealed a higher incidence of cesarean section deliveries in the GDM group (p<.05). Additionally, infants born to mothers with GDM had a higher risk of neonatal complications. Conclusions: Women diagnosed with GDM demonstrated distinct clinical characteristics and experienced a higher incidence of adverse pregnancy outcomes. These findings underscore the importance of effective management and close monitoring of pregnant women with GDM to optimize maternal and neonatal health. J Rang Med Col. March 2024; Vol. 9, No. 1: 28-32

Preference and Associated Factors for Cesarean Delivery Among Pregnant Women: A Cross-Sectional Study

Objective: A cesarean delivery is regarded as a comparatively favourable and secure approach to childbirth when contrasted with vaginal delivery. Over the past decade, its frequency has risen in both industrialized and developing nations. Maternal request for cesarean delivery has been explained for the escalating rate along with other factors like anxiety, fear of childbirth, previous cesarean delivery, previous negative vaginal birth experience, maternal age, maternal education, and socioeconomic factors. Hence, this study was undertaken to assess pregnant women's tendency to have a cesarean birth and to investigate the factors associated with the inclination for cesarean delivery. Materials and methods: A hospital-based cross-sectional study was carried out in the Department of Obstetrics and Gynaecology of a tertiary care hospital, a systematic sampling procedure was utilized, and 368 antenatal mothers after 36 weeks of gestation, who do not have any specific medical reasons against vaginal delivery were included in the study. Data collection was done by questionnaire. The information regarding socio-demographic factors, preexisting comorbidities, current obstetric risk factors, emotional factors, previous delivery experience, and their information preference toward the mode of delivery were collected. Univariate and multivariate analysis were performed to identify the independent variables associated with preference for cesarean delivery. Results: The preference for cesarean delivery and non-preference for cesarean delivery was 114 (30.9%) and 201 (54.6%), respectively whereas 53 (14.4%) participants remained neutral. The Chi-square analysis revealed a notable connection between the inclination towards a preference for cesarean delivery and factors such as obstetric score, parity, comorbidities, and among obstetric risk factors such as pregnancy after in-vitro fertilization (IVF), with a history of abortion, and having a prior history of cesarean delivery. Nevertheless, no meaningful association was observed between the preference for cesarean delivery and the remaining variables. On multivariate logistic analysis, independent variables like preexisting anxiety or depression, pregnancy through IVF, and having a history of previous cesarean delivery have increased the odds of preferring cesarean delivery. The independent variables like increasing gestational age, graduates, and unemployed have decreased the odds of preferring a cesarean delivery. Conclusion: In conclusion, the prevalence of cesarean delivery is influenced by a complex interplay of medical, cultural, socioeconomic, and healthcare system factors. While cesarean delivery is essential in cases of medical necessity, efforts should be made to avoid unnecessary cesarean delivery that does not provide clear benefits over vaginal delivery. Balancing the risks and benefits of cesarean delivery and promoting evidence-based obstetric practices are crucial for ensuring optimal maternal and infant outcomes.