Government Maternity Hospital Research Articles

The Aplastic Crisis in HbSS: Observations from the Jamaican Birth Cohort

In order to document the prevalence, clinical features, hematology and outcome of the aplastic crisis in homozygous sickle cell disease (HbSS), a cohort study has been conducted from birth. Newborn screening of 100 000 deliveries at the main government maternity hospital, Kingston, Jamaica between 1973 and 1981 detected 311 cases of HbSS who have been followed at the Medical Research Council Laboratories at the University of the West Indies, Kingston, Jamaica. Clinically defined aplastic crises occurred in 118 (38%) patients at a median age of 7.5 years (range 0.5–23.0 years). All but one event seroconverted to parvovirus B19, the exception being a 9.3 year male with classic aplasia but subsequent IgG did not exceed 3 IU. Defined by zero reticulocyte counts, 94 patients presented with a median hemoglobin of 3.7 g/dL (range 18–87 g/L) representing a median fall from steady state levels of 3.8 g/dL. Clear epidemic peaks occurred at 1979–1980, 1984–1986, and 1990–1993 and the admission rate and use of blood cultures fell with each epidemic, reflecting increased familiarity with the complication. Symptoms were usually nonspecific and all but 7 were transfused. No patient had a recurrence and two died from aplasia (one with remote rural residence and the other following an incorrect diagnosis). Of those seroconverting to parvovirus B19, 68% manifested aplasia and 24% had no hematologic change. Correctly diagnosed and managed, the aplastic crisis is essentially benign. (230 words)

Effect of maternal age on the rate, type, and indications of caesarean section deliveries: A study from a maternity hospital of Peshawar, Pakistan.

Objective: To evaluate the effect of maternal age on the rate, type (elective or emergency) and indications of caesarean section. Study Design: Cross-sectional study. Setting: Government Maternity Hospital, Peshawar. Period: January 2020 to January 2021. Methods: The normal labor register, which contains data of each, and every delivery conducted in the mentioned hospital, was used to find out total number of caesarean sections during the period of study. All those patients were included in the study who underwent caesarean section during the study period. Total number of caesarean sections was 603 after excluding the patients with ruptured uterus, multiple pregnancies, ectopic pregnancy and cephalopelvic disproportion. Maternal age was noted and compared with the rate of caesarean section. Maternal age was further categorized as <20; 21-25; 26-30; 31-35; 36-40 and >40 years. Results: Among 603 patients, the majority of patients who underwent caesarean section were in 26-30 years age group followed by 21-25 years. When the indications for caesarean section were compared based on the already defined categories of age, a significant difference (p<0.001) was found. Previous caesarean sections were found to be the topmost cause in all age groups while the second common cause was malpresentation. Elective caesarean section rate was found to be significantly higher than emergency ones with p-value<0.001. Conclusion: Our results revealed a greater number of caesarean sections in the younger age group; therefore, it can be concluded that maternal age has no direct effects on the rate, type, and indications of caesarean section.

Comparison of the rate and indications of caesarean section in primigravida and multigravida in a maternity hospital of Pakistan.q

Objective: To compare the causes and rate of caesarean section in primigravida and multigravida. Study Design: Cross-sectional study. Setting: Government Maternity Hospital, Peshawar. Period: January 2021 to January 2022. Methods: The study included all primigravida with 37-42 weeks period of gestation, and multigravida (gravida 2-12) with the same gestational period. Similarly, all the multigravida who delivered previously by C-section or had normal vaginal delivery with the viable fetus and currently delivered by C-section, were also included. Cases having history of ruptured uterus, nonviable pregnancy and ectopic pregnancy were excluded from the study. Results: Overall, the frequency of C-sections in the present study was 30% in primigravida and 70% in multigravida. Majority of the patients (65%) went through elective C-sections while 35% delivered through emergency C-sections, difference between the two is statistically significant (p-value <0.0001). The commonest cause for performing elective C-sections was previous C-sections. Fetal distress was the commonest indication 27.27% for emergency C-sections. Most of the C-sections performed in primigravida were because of fetal distress 23.3% while previous C-sections were the topmost cause in multigravida. Maternal wish is another new indication that accounted for 7.6% of C-sections. Conclusion: The results showed that the incidence of C-sections was higher in multigravida than primigravida. Similarly, the rate of elective C-sections was more than emergency ones. Maternal wish is another rising new indication for C-sections.

Assessment of Oral Health Status and Treatment Needs among a Cohort of Pregnant Women in Hyderabad City – A Cross-sectional Survey

Abstract Aim: The aim of this study was to assess the oral health status and treatment needs of pregnant women visiting the Osmania Government Maternity Hospital in Hyderabad, India. Materials and Methods: A cross-sectional survey was conducted for about 5 months, encompassing 606 pregnant women. In the clinical oral examination, the community periodontal index (CPI), loss of attachment (LOA), dentition status, and treatment needs were recorded using the World Health Organization 1997 pro forma. The data were analyzed using SPSS software version 22.0. Results: On periodontal examination, 279 (46%) subjects had calculus (Code “2”), and 219 (36.1%) respondents presented with shallow pockets (Code “3”) on probing. Furthermore, more than half of the study participants (353; 58.3%) had an LOA of 4–5 mm (Code “1”). Women in the third trimester had a significantly (P < 0.001) higher mean number of sextants affected with CPI Code “1” (1.94 ± 1.08), Code “3” (1.03 ± 1.14), Code “4” (0.09 ± 0.37), and LOA Code “2” (0.13 ± 0.40). Likewise, study participants who conceived three or more times had a significantly higher mean number of sextants affected by CPI Code “3” (1.09 ± 1.14; P < 0.001), LOA Code “1” (2.22 ± 1.53; P < 0.001), and LOA Code “2” (0.12 ± 0.36; P = 0.02). The mean decayed missing filled teeth (3.91 ± 3.25, 4.00 ± 3.24) and decayed teeth (3.83 ± 3.25, 3.96 ± 3.24) showed a significant (P = 0.0001) relationship with women in the third trimester, those who conceived three or more times. Based on treatment needs, 420 (69.3%) teeth are in need of one surface filling, 217 (35.8%) teeth require two or more surface fillings, and pulp care and restoration were needed in 213 (35.1%) teeth. On a note, a greater percentage of the participants (84%) had never been to the dentist. Conclusion: The study emphasizes the need to structure preventive oral health education programs at regular intervals targeting expecting women.

Knowledge and attitude of antenatal mothers on the preconception and prenatal diagnostic techniques act attending Government Maternity Hospital in Andhra Pradesh: A cross-sectional study

Background: Girl children are vulnerable to gender biases throughout the economic and social strata. From the moment of conception, a girl’s existence is an ongoing struggle for survival, development, and growth. Gender equality has gained recognition in the past 10 years as essential to a country’s social and economic progress and overall health. Aims and Objectives: The aim of the study was to know the awareness and attitude of antenatal mothers regarding the preconception and prenatal diagnostic techniques (PCPNDT) act, gender preference, and their awareness regarding related social issues. Materials and Methods: A hospital-based cross-sectional study was conducted after obtaining ethics committee approval and consent from 200 antenatal mothers attending a maternity hospital from September to December 2022. Data were collected using a predesigned, pre-tested, semi-structured questionnaire. The analysis was done with Statistical Package for the Social Sciences software version 26.0. Results: Out of 200 study subjects, 80% were in the age group of 19–25 years, 60.5% were aware of the PCPNDT act, and 43.8% of mothers had knowledge about the PCPNDT act from hospital sources. Of the 56% of mothers who preferred a male child, 35.7% said it was first being a girl child. In this study, awareness of the PCPNDT act was significantly associated with age, area of living, religion, education, occupation, and socio-economic status, but not with type of family. Conclusion: Despite better knowledge regarding the PCPNDT act, the attitude toward sex determination, female foeticide, and son preference has to be changed. For this reason, strict implementation of the PCPNCDT act is essential.

Acute splenic sequestration in HbSS: observations from the Jamaican birth cohort

ObjectiveTo document the prevalence, clinical features, haematology and outcome of acute splenic sequestration (ASS) in homozygous sickle cell disease (HbSS).Study designA cohort study from birth.SettingThe Medical Research Council Laboratories at...

A Prospective Observational Study on Causes and Effectiveness of Oligohydramnios Treatment in Pregnant Women with Different Comorbidities

Oligohydramnios is a rare condition characterised by decreased amniotic fluid volume for gestational age. To determine the causes and effectiveness of oligohydramnios treatment in oligohydramnios pregnant women. We conducted a prospective and observational study at GMH (Government Maternity Hospital) in Hanamkonda over a period of 6 months. We included 203 oligo patients in this study and in which patients were grouped as 3 categories based on amniotic fluid index (AFI) as mild, moderate, severe. Information of the patients were collected from patient case reports and face to face interactions. The data was analysed through EXCEL. From our study we can conclude that oligohydramnios treatment is showing improvement in mild, moderate and severe oligohydramnios patients. But patients with uncontrolled hypertension were not showing liquor improvement because of their decreased placental perfusion. Gestational diabetes and thyroid do not cause oligohydramnios in pregnancy condition.

A STUDY TO ASSESS THE EFFECTIVENESS OF BENSON’S RELAXATION THERAPY IN ANXIETY BETWEEN PRE-TEST TO POST-TEST AMONG EXPERIMENTAL AND CONTROL GROUPS WITH HIGH-RISK ANTENATAL MOTHERS AT SELECTED HOSPITALS IN WARANGAL, TELANGANA

In 2017, every day approximately 808 women died due to pregnancy complications. Most of the deaths occurred in low-resource countries. The primary causes of maternal deaths are hemorrhage, hypertension, infections, and indirect causes like accidental or incidental causes. Mostly due to interactions between medical conditions and pregnancy complications. A quantitative research approach was adopted for this study. The research design used for the present study was quasi experimental, non-equivalent group design. The population included in this study was high-risk antenatal mothers with anxiety at selected hospitals, in Warangal, Telangana. Government Maternity Hospital at Warangal, Telangana. Kalyani Nursing Home at Warangal, Telangana. Sri Laxmi Maternity Hospital, Warangal, Telangana. had been selected for undertaking this look at. Hospitals have nicely prepared and established specialized separate Obstetrics and Gynaecological department with close to 100 Outpatient go to in line with day, nearly general a hundred of inpatient bed satisfy through ordinary admission and nearly greater than 100 affected persons visit hospital for regular consultancy in OPD in line with day. The sample size consist of 500 high risk antenatal mothers with anxiety at selected hospitals, Warangal, Telangana. Non probability Convenience sampling technique was used for this study.

TO STUDY AND ASSESS THE VALIDITY OF THE RISK OF MALIGNANCY INDEX(RMI-4) IN DISCRIMINATING BETWEEN BENIGN AND MALIGNANT OVARIAN MASSES

Introduction:The most fatal of all gynecological cancers is ovarian cancer. Of all gynecological cancers, it has the greatest fatality-to-case ratio. It is the 4th most prevalent cancer among women. The lifetime risk of being diagnosed with ovarian carcinoma is 1% to 1.5 %, with a nearly 0.5% chance of dying from it. Suboptimal primary cytoreductive surgery has great prognostic significance. The reason was because of inappropriate preoperative evaluation, which decides the kind of surgery being performed and the surgeons expertise of the surgeon in performing staging laparotomy if indicated. Hence, a gynecologist must be able to differentiate benign from the malignant ovarian mass. Several studies have revealed that the diagnosis of ovarian mass by investigations like Ultrasonogram, Doppler, MRI, CT has been proved to be uncertain despite the need for expertise. The goal of this study was to assess the ability of the Risk of Malignancy Index Scoring System (RMI- 4) in differentiating benign from malignant ovarian masses and to compare the scoring patterns to histopathological findings. Objectives: To validate the efficiency of the Risk of Malignancy Index(RMI-4) in discriminating benign and malignant ovarian tumors.To correlate the calculated value of the Risk of Malignancy Index(RMI-4) to the histopathological report.To evaluate the performance of individual parameters and the Risk of Malignancy Index(RMI-4) in differentiating benign and malignant ovarian tumors. Materials and methods: A prospective observational study in one year from date of approval from institutional ethical committee i. e from 2019 to 2021on women attending Gynecology outpatient and inpatient department diagnosed with an ovarian mass at Government Maternity Hospital, Tirupati. Results : 50 women with ovarian mass were selected for the study. Patients with endometriosis, fibroid uterus, Pelvic inflammatory disease, menstruation, pregnancy, ectopic pregnancy, and other non-gynecological conditions like peritonitis, diverticulitis, inflammatory bowel disease, tuberculosis, liver disease, recent surgery, are excluded. General and gynecological examinations were done for all cases. Ultrasound pelvis was done for all the patients and the presence of bilateral ovarian mass, multiloculated tumor, presence of solid areas, ascites, and extra ovarian metastasis was noted. An ultrasound score (U) of 1 was given if none or one of the features are found, and a score of 4 was given if two or more of these features were noted. Size of the tumor measured. A score of 1 was given for a tumor less than 7 cm and a score of 2 for a tumor size more than or equal to 7 cm size. Postmenopausal status was defined as more than one year of amenorrhea or age older than 50 years for women who had undergone hysterectomy they were scored as M=4. All other patients who did not meet these criteria were defined in a premenopausal status which scored M=1. The Risk of Malignancy Index (RMI-4) was calculated by using the formula: RMI-4 = U x M x S x CA 125. Laparotomy was done for all cases and the specimen was sent for histopathological examination which is the gold standard.90% of the tumors were benign and 10% were malignant.Prediction of malignancy by CA 125, ultrasound, and RMI-4 was analyzed.The optimal cut-off value of RMI-4 was 450 with a sensitivity of 95.56%, specificity of 100%, PPV of 100%, and NPV of 71.43%.Though the Specificity and PPV of CA125 were high, Sensitivity was less (86.67%).This study showed that RMI-4 had better performance than CA 125, USG score, and menopausal score in predicting malignancy. Conclusion:RMI-4 is a multimodal approach that is simple and easily applicable in the preoperative evaluation of a patient with an ovarian mass.Risk of Malignancy Index -4 (RMI-4) is a reliable method in discriminating benign and malignant ovarian mass preoperatively.Risk of Malignancy Index -4 (RMI-4) is a better scoring index in differentiating benign and malignant ovarian mass when compared to individual tests of ultrasonogram or CA125 level.The optimal cut-off point of Risk of Malignancy Index -4 (RMI-4) at which benign and malignant tumors can be discriminated was 450 in the present study.RMI-4 is the most useful scoring system in the proper selection of patient.Since the specificity of Risk of Malignancy Index -4 (RMI-4) was high, there is a potential role for this index in the selection of cases for conservative management or minimally invasive surgery in case of benign ovarian masses.

Primary amenorrhea with mullerian duct anamolies with hypoplastic uterus-mayer rokitansky kustner hauser syndrome a case report

Aim: To report a case of Mayer rokitansky kustner hauser syndrome in the Government Maternity Hospital (Tertiary Health Care Center).Materials and Methods: A 17-year-old resident of Pileru, unmarried presented to the gynecology OPD at government maternity hospital, Tirupati with complaints of not attaining menarche. On examination her vitals are stable, height 150cm, weight 48kgs, BMI 21.3 kg/m². Bilateral breast tanner stage 4, pubic hair tanner stage 4. Per abdomen soft, external genitalia healthy, per rectal examination not able to palpate uterus.

The correlation between parity and incidence of premature rupture of membranes

Objectives: To identify the correlation between parity and premature rupture of membrane (PROM) incidence at Government Maternity Hospital, Tirupati in 2022.Methods: This is a retrospective observational study conducted in a Tertiary Care Hospital in Andhra Pradesh from May 2022 to July 2022. The study population was all pregnant women giving birth at Tertiary Care Hospital from May to July 2022. The samples used in this study were 2965 women who delivered in Tertiary Care Hospital among them patients with PROM 312. The data were secondary data obtained from medical records and then analyzed in univariate and bivariate analysis using a chi-square test with p-value = 0.007. Results: The incidence of premature rupture of membrane at Tertiary Care Hospital is 10.5%. Incidence in Primi’s is 2.4% and multi para’s is 4.6%.The research results showed that most PROM incidences occurred in primipara as many as 72 respondents (8.3%), and those who did not experience PROM occurred in multipara were as many as 777 respondents (28.5%). Chi-Square (X2) statistical test obtained p-value = 0.007 so that it can be concluded that there was a correlation between parity and the incidence of premature rupture of membranes in Tertiary Care Centre in Tirupati from May 2022 to July 2022.Conclusion: Mothers in Tertiary Care Centre, Tirupati mainly were multipara. There is a relationship between parity with the incidence of premature rupture of membranes in Tertiary Care Centre from May 2022 to July 2022 with p value = 0.007. Further research is needed and develop this title by connecting to other variables so that the results obtained will be more comprehensive.

To study the maternal risk factors for fetal growth restriction in pre-term births

Introduction: Fetal growth restriction and preterm birth are the two adverse pregnancy outcomes, which remains a prime challenge in maternity careMaterials and Methods: One year retrospective study was conducted in government maternity hospital, Tirupati, to know the maternal risk factors for fetal growth restriction in preterm birthsResults: Underweight and manual labor during pregnancy are the significant risk factors for fetal growth restriction in preterm births.Conclusion: Preterm fetal infants have 2 times higher risks of need for NICU admission and 5 times risk for Neonatal mortality when compared to preterm non-fetal growth restriction infants.

Awareness and acceptance of contraception in postpartum women at tertiary care hospital

Introduction: Contraception is defined as prevention of conception voluntarily through use of various methods like condoms, sexual practices, drugs (progesterone, oral contraceptive pills etc.) surgical procedures. Any method whose purpose is to prevent women becoming pregnant is considered as contraceptive method. The aim of Contraception is to achieve maximum comfort and privacy with minimum cost and side effects. Contraception allows a couple to enjoy physical relation without fear of unwanted pregnancy and to beget child when desired.Materials and Methods: A cross-sectional questionnaire-based study carried out in the Department of Obstetrics and Gynecology at Government Maternity Hospital, Tirupati. A total of 300 postpartum women were enrolled in the study.Results: Among 300 women in the study group, more than 80% were in the age group of 15 to 30 years.51.7% women in urban areas, 48.3% women in rural areas. Acceptance was highest in women with 2 to 3 children. Maximum number of women were aware of female sterilization (90.1%), condoms (88%), intra uterine device (77.6%), OC pills (75.2%), POP’s (56%). Knowledge regarding emergency contraception was very low (2.9%). In our study at present 48% of postpartum women were using IUCD and 12% opted for female sterilization.Conclusion: Awareness of contraception given when pregnant women comes for first antenatal visit. Cafetaria approach according to the women needs.

Study of fetomaternal outcome of teenage pregnancy in a tertiary care hospital

Background: The objective is to study the fetomaternal outcome in teenage pregnancy at Government Maternity Hospital, S V Medical College, Tirupathi for the study period of 1 year from June 2021 to May 2022. Teenage pregnancy is a worldwide health problem. WHO defined adolescence as the period from 10-19 years? It is a serious health problem in a developing country like India. Teenage pregnancy is associated with high risk of prematurity, low birthweight, preeclampsia and anaemia.Methods: It is a retrospective study conducted in a tertiary care hospital at GMH, SVMC, Tirupathi over a period of 1 year. 1325 teenage pregnant women were included in the study out of 12992 pregnant women admitted for delivery during the study period. Results: Study showed the incidence of teenage pregnancies as 10.1%. Among these teenage pregnant women 87% had anemia, 21.6% had gestational hypertension, 7% had eclampsia, 6% had intrauterine death and malpresentations were noted in 4%. Intrapartum complications noted in the study are preterm labor (41.9%), cephalopelvic disproportion(25.8%), fetal distress(22.4%) and obstructed labor(0.3%). 52 cases were complicated with postpartum hemorrhage, 2 with puerperal sepsis and 6 with retained placenta. 2 cases of maternal deaths occurred due to antepartum eclampsia and pulmonary edema. LSCS rate was 27%, 65.9% had normal vaginal deliveries and 11.9% had instrumental deliveries. Among the total births 57.8% were low birth weight.Conclusions: Teenage pregnancy is associated with increased incidence of anemia, pre-eclampsia, eclampsia, preterm delivery, instrumental delivery, low birth weight and perinatal death. The healthcare provider should consider teenage pregnancy as high risk pregnancy and should emphasise for more number of antenatal visits to identify the risk as early as possible.

Symptomatology and course of COVID-19 infection among vaccinated and unvaccinated pregnant women admitted to a referral hospital

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a novel strain of Coronavirus (2019-nCoV). India is one of country which is largely affected by COVID-19 during 1st and 2nd wave of COVID-19. This study includes the pregnant women who are vaccinated before pregnancy or antenatally, who later developed COVID 19 infection. In these women interval between vaccination and COVID 19 positive, and outcome among vaccinated.Methodology: 3 months prospective hospital based cross sectional study in designated COVID hospital under care of Government Maternity Hospital, Tirupati, to compare outcome of pregnant women with COVID 19 infection who are vaccinated to the unvaccinated pregnant women. Sample size was 27.Results: From the present study it can be seen that the course of COVID 19 infection is mild in case of fully vaccinated women and stormy in case of some unvaccinated women but even partial vaccination with one dose offers some amount of protection from morbidity and mortality.Conclusion: Because these studies were carried out in months of July, august, September, most of women could receive only first dose. The sample size in this study is a limitation. We need studies with a larger vaccinated population to draw solid conclusions. There is also need for separate studies regarding different brands of vaccine.

Prevalence of overt and subclinical thyroid dysfunction in pregnant women and outcome in a tertiary care centre

Aim: To know the prevalence of overt and subclinical thyroid disorders in Indian pregnant women and to know the effect of overt and subclinical thyroid dysfunction on maternal and fetal outcome.
 Materials and methods: This study was conducted at the Government Maternity Hospital, sultan bazaar, Osmania medical college, Hyderabad over a period of 15 months from august 2016 to October 2017. 1000 pregnant women who attended the antenatal clinic were screened for the thyroid dysfunction. Serum TSH level estimated. fT3, fT4 and anti TPO Ab levels were estimated if the TSH level was abnormal. Patients were managed accordingly and followed till the delivery. Maternal and fetal outcome recorded.
 Results: It was a prospective study done on 1000 antenatal women. Prevalence of thyroid disorder in this study was 11.3%. Prevalence of subclinical, overt hypothyroidism, subclinical and overt hyperthyroidism was 9.4%, 1.4%, 0.4% and 0.1% respectively. Subclinical hypothyroidism was associated with complications like preeclampsia (13.8%), Anaemia (15.95%), preterm delivery (6.38%), Intrauterine growth restriction (4.25%), low birth weight (12.76%) and Intrauterine fetal death)(2.12%). Overt hypothyroidism was associated with complications like Preeclampsia (14.28%), anaemia (21.4%), Preterm delivery (14.28%), intrauterine growth restriction (14.28%), low birth weight (21.4%) and Intrauterine fetal death (7.14%). Incidence of CD was 18.05% in women with hypothyroidism. Subclinical hyperthyroidism was associated with complications like Preeclampsia, Preterm delivery, Intrauterine growth restriction, Intrauterine fetal death.
 Conclusion: Thyroid disorders in pregnancy are significantly associated with both maternal and fetal complications and adversely affect the outcome of pregnancy. Hence, early identification of thyroid disorders and timely initiation of treatment is essential

Awareness and acceptance of contraception in postpartum women at government maternity hospital, Tirupati

Introduction: Contraception is an important intervention to decrease unwanted pregnancies and promote healthy and better living among women. As the population continues to rise, there will be overcrowding, a limiting of resources, and the quality of life will decline. India, as the first country in the world, initiated the National Family Planning program in the year 1951 with the objective of “reducing the birth rate to the extent necessary to stabilize the population at a level consistent with requirement of national economy.”Methodology: It is a cross sectional questionnaire-based study carried out in the Department of Obstetrics and Gynaecology at Government Maternity Hospital, Tirupati. A total of 300 postpartum women were enrolled in the study who are briefed about study. After taking informed consent, they were interviewed based on a predesigned questionnaire they were allowed to choose any method of contraception they like. Their level of awareness, acceptance, and reason for refusal was assessed.Results: Among 300 women in the study group, more than 80% were in the age group of 15 to 30 years.51.7% women in urban areas, 48.3% women in rural areas. Majority of the women were Hindus. 89.3% women were literates and majority of them were house wives. Most of the women had only one living issue. It was observed that both were highest in educated working women, urban population. Acceptance was highest in women with 2 to 3 children. Maximum number of women were aware of female sterilization (90.1%), condoms (88%), intra uterine device (77.6%), OC pills (75.2%), POP’s (56%). Knowledge regarding emergency contraception was very low (2.9%).Conclusion: There is still date lack of awareness of contraception in some postpartum women. Regular counselling is a must to all pregnant women from every health care centre in a village to super speciality centres in cities. Information should be provided about various methods of contraception and patient should be able to choose a method of her choice.

ABNORMAL VAGINAL DISCHARGE IN REPRODUCTIVE AGE GROUP WOMEN WITH SPECIAL IMPLICATION TO ANTIFUNGAL SUSCEPTIBILITY OF CANDIDA SPECIES

Introduction And Background: Vaginal discharge is a common complaint in reproductive age group women2. Vaginal discharge is one of the common reasons in women of reproductive age group seeking gynecological consultation. It is the second most common clinical problem after menstrual disorders. Globally, it is estimated that one in ten women will present with vaginal discharge in the course of one year and approximately, ten million office visits each year are attributed to vaginal discharge complaints. The prevalence of vaginal discharge in India is estimated to be 30%3. Ÿ Abnormal vaginal discharge predisposes to significant morbidity to the women in the form of pelvic inflammatory disease, infertility, endometriosis, cuff cellulitis, urethral syndrome, pregnancy loss, and preterm labour.5 Ÿ Certain conditions such as prolonged use of combined oral contraceptive, pregnancy, malnutrition, diabetes, neutropenia, prolonged antibiotic therapy, candida become pathogenic and causes candidiasis.8 Ÿ Isolation, identification, characterization, and susceptibility of candida species became critical management of fungal infections.9 Need For The Study: The study was done to emphasize the role of laboratory investigations in patients with vaginitis, as presumptive clinical diagnosis alone can lead to false interpretation and treatment mismanagement. TheMethods: present study is a cross sectional observational study conducted from January 2019 to February 2020 for about a period of one year among 300 women aged 15-49 years with vaginal discharge attending gynecology OPD, Government Maternity Hospital, Tirupati. This study included 300 subjects with a mean age of 30.4 ± 7.26 years. Nearly halfResults: of (49.33%) our study population was aged between 25 to 34years, a majority (47%) of women had bacterial vaginosis, followed by Candida in 39.33%, trichomonas vaginalis in 14.33%, mixed infections in 6.67% and 6% with no organisms. Among Candida species, 48.31% of participants had candida albicans, 23.73% had candida tropicalis, 19.49% had candida krusei, and 8.47% had candida glabrata, and of them 38.33% participants had voriconazole sensitivity, 32.33% participants had ketoconazole sensitivity, 26% participants had clotrimazole sensitivity, and 21.33% participants had fluconazole sensitivity. Among 118 candida infected 106 (89.83%) participants came for follow-up, of which symptoms subsided in 90 (84.91%) participants. In conclusion, our study with 300 women patients complaining ofConclusion: vaginal discharge found a majority of them belonging to the sexually active age group. Vaginal discharge was more prevalent in lower economic status and rural areas. Bacterial vaginosis was the most common and frequent etiology, followed by Candida. TV was the least common etiology for vaginal discharge.

Comparative study on estimation of fetal weight in term pregnancy by clinical methods and USG with actual birth weight in a tertiary care center

Background: Primary goal in modern obstetrics is to deliver a healthy baby in a healthy mother. Birth weight is the most important factor in determining the neonatal outcome and survival.1 So the accurate estimation of fetal weight is one of the important aspects in management of labour.2 objectives: To compare the accuracy of estimated fetal weight by USG and clinical methods with actual birth weight. Material & Methods: Study Design: Prospective hospital based cross – sectional study. Study area: Department of Obstetrics & Gynaecology, Modern Government Maternity Hospital, Osmania Medical college, Petlaburj, Hyderabad, Telangana state. Study Period: Feb. 2021 - Jan 2022. Study population: Pregnant women attending Obstetrics and Gynaecology department, Modern Government Maternity Hospital, Osmania Medical college, Petlaburj, Hyderabad. Sample size: Study consisted a total of 200 cases. Results: There was no significant difference between actual birth weight and USG, Johnson and Dare’s formula estimated weight. It is inferred that all the methods are more or less accurately estimated the actual birth weight. But, when compared to the other two methods, USG estimate was more accurate as the mean difference between USG estimate and actual birth weight was found to be very less ie. 13.00 g.

Prevalence of gestational diabetes mellitus along with maternal and fetal outcome in government maternity hospital, Tirupati

Background: Gestational diabetes mellitus (GDM) is a metabolic disorder defined as glucose intolerance with the onset or first recognition during pregnancy. Women with GDM are at increased risk for adverse obstetric and perinatal outcome. Aim, To find the prevalence of Gestational diabetes mellitus among antenatal women and to diagnose Gestational diabetes mellitus among antenatal women between 24-28 weeks gestational age by modified Glucose challenge test and to study maternal and fetal outcome. Materials and methods: A prospective and observational study conducted in the antenatal women between 24 to 28 weeks gestational age attending outpatient selected as study subjects. The number of cases included in the study was 2000. Results, All patients accepted the test readily and no adverse effects were observed. In the present study GCT positive in 58 cases of which 55 cases were OGTT positive and diagnosed as GDM cases. Prevalence of GDM was found to be 2.75% in the 2000 patients studied. More than 25 years of age group had more prevalence of GDM. In the present study 41.82% were primigravida and 59.18% were multigravida, prevalence increased with gravidity.