Outpatient Department Of Obstetrics Research Articles

P-323 Endometriosis and adenomyosis present lower expression in uterine natural killer cells

Abstract Study question Is there an association between endometriosis and uterine natural killer cells? Summary answer Decreasing level of uterine natural killer cells had positively associated with Endometriosis and Adenomyosis. What is known already Uterine natural killer cells (uNK) represent the predominant lymphocyte population within the decidua during implantation and in the initial stages of pregnancy. Dysregulation of uNK function has been associated with reproductive challenges, including recurrent miscarriage (RM) or recurrent implantation failure (RIF). This suggests an underlying disruption in immune activity during implantation. Endometriosis is a chronic and inflammatory disorder that usually affects the pelvic cavity and can cause severe pain during menstruation. However, there are paucity studies focus on the role of uNK in endometriosis and adenomyosis. The aim of this study was to identify the association between endometriosis and uNK. Study design, size, duration In this Prospective cohort study, 60 participants were recruited from May 2023 to January 2024 at the outpatient department of Obstetrics and Gynecology in Chang Gung Memorial Hospital, Kaohsiung Medical Center in Taiwan. The inclusion criteria were as follows: adult women of childbearing age were eligible to participate. Old age (>45 years old) patients, or patient with underlying medical disease, immune diseases and malignancy, or patient using immunosuppressant were excluded. Participants/materials, setting, methods Endometrial tissues were collected during the mid-luteal phase using an endometrial curette. The level of uNK were measured by immunohistochemistry with CD56+, and was presented in absolute number per high power filed. CD138 was also measured, and the level above 5 cell/HPF was defined as chronic endometritis. Endometriosis and adenomyosis were confirmed histologically. RM was defined as ≧2 previous miscarriages. RIF was defined as ≧2 previous failures to achieve clinical pregnancies after embryo transfer. Main results and the role of chance At least one uNK/HPF was revealed in 58 cases, 0-10uNK/HPF in 15 cases (24.5%), 11-20 uNK/HPF in 19 cases (31.6%) and above 20 uNK/HPF in 26 cases. After adjusting for covariates, patient with endometriosis and adenomyosis were positively associated with lower uNK level(low vs. high uNK(cut-off value: 20 uNK/HPF), odds ratio (OR) (95% confidence interval (CI)), 9.434 (1.101–83.33), p = 0.032; 2.000 (1.515–2.639), p = 0.015). Moreover, there are 14 patients with RM (23.3%), 26 patients with RIF (43.3%) and 7 patients with CE (11.7%). However, our study did not find significantly association between RM or RIF or CE with uNK levels. Limitations, reasons for caution Because of the single-center, Asian origin of our patients, and the sample size was relatively small. Further large-scale longitudinal studies are required to verify our findings and evaluate the underlying pathophysiology between endometriosis and uNK. Wider implications of the findings Our study highlights the significantly decreased uNK level in endometrium of women with endometriosis and adenomyosis, which may indicate some alteration in immune environment under endometriosis. Further research is warranted for understanding the immuno-modulation in endometriosis. Trial registration number not applicable

Hypothyroidism and Its Impact on Menstrual Irregularities in Reproductive-Age Women: A Comprehensive Analysis at a Tertiary Care Center.

Hypothyroidism is known to affect a wide range of physiological systems, including menstrual function, in women of reproductive age. This study aims to comprehensively analyze the association between hypothyroidism and menstrual irregularities in women attending a tertiary care center. The study included 120 women aged 18-45 who presented with menstrual abnormalities. Convenience sampling was used to select participants from the outpatient department of obstetrics and gynecology. Thyroid function tests were conducted in the hospital's biochemistry laboratory, including assessments of thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), and thyroid peroxidase antibodies (TPOAb). The study aimed to determine the prevalence of hypothyroidism and its association with various menstrual irregularities, such as oligomenorrhea, polymenorrhea, menorrhagia, and amenorrhea. Data analysis was performed using SPSS software, applying descriptive statistics, Pearson correlation for continuous variables, and Chi-square tests for categorical variables. A significance level of p<0.05 was set for the analyses. The mean age of the participants was 33.1 years (SD ± 7.2). The distribution of menstrual irregularities was 60 (50%) oligomenorrhea, 24 (20%) polymenorrhea, 24 (20%) menorrhagia, and 12 (10%) amenorrhea. Elevated TSH levels (>4.0 mIU/L) were observed in 42 (35%) of the participants, low FT4 levels (<0.8 ng/dL) in 18 (15%), low FT3 levels (<2.5 pg/mL) in 12 (10%), and elevated TPOAb levels (>55 IU/mL) in 24 (20%). A significant association was found between elevated TSH levels and oligomenorrhea (66 (55%), p<0.05) and between reduced FT4 levels and menorrhagia (78 (65%), p<0.05). Additionally, elevated TPOAb levels were significantly associated with amenorrhea (60 (50%), p<0.05). The correlation analysis showed a moderately positive correlation between TSH levels and the severity of menstrual irregularities (r=0.35, p<0.01). Subclinical hypothyroidism was detected in 25% of the participants, while 15% had clinical hypothyroidism. This study underscores a notable link between hypothyroidism and menstrual irregularities in women of reproductive age. The results highlight the necessity of routine thyroid function screenings for women experiencing menstrual abnormalities, facilitating precise diagnosis and suitable treatment.

Quantifying the Occurrence of High-Risk Pregnancy: A Comprehensive Survey.

Background High-risk pregnancies are characterized by various factors that pose potential risks to maternal and newborn health outcomes. Early detection of these high-risk pregnancies serves as a crucial initial step in preventing maternal mortality and morbidity, thereby promoting the overall health of both mother and baby. This study sought to assess the occurrence of high-risk pregnancy and investigate the factors associated with it among pregnant women. Methods A descriptive survey was undertaken at the Obstetrics and Gynaecology outpatient department of a District Government Hospital in Tamil Nadu, involving 1889 pregnant women in their second and third trimesters. A structured questionnaire, constructed following the Indian standard criteria outlined by the National Health Portal of India, served as the data collection tool. The survey was conducted in February and March 2022, during which pregnant women were interviewed. Subsequently, the collected data underwent descriptive and inferential statistical analysis. Results Among the 1889 pregnant women surveyed, 29% (n=530) were classified as high-risk pregnancies. Within this group, 34.3% (n=182) were diagnosed with hypothyroidism, while 23.2% (n=123) experienced pregnancy-induced hypertension. Significant associations with high-risk pregnancy were observed for factors such as age, education status, occupation, family income, socioeconomic status, and gravida among the pregnant women. Conclusion Policymakers must urgently implement evidence-based interventions aimed at early detection and treatment of high-risk pregnancies. This proactive approach is essential in preventing maternal mortality and morbidity.

Association of Serum Homocysteine with Gestational Diabetes Mellitus (GDM): A Case-Control Study

Gestational diabetes mellitus (GDM) is associated with an increased risk of maternal and fetal mortality and morbidity. There is an increasing trend in the prevalence of GDM in Bangladesh. The role of homocysteine (Hcy) as an independent risk factor of GDM has not been extensively studied. The aim of this study was to evaluate the association of serum homocysteine levels in gestationaldiabetes mellitus. It was a case-control study among pregnant women attending the inpatient and outpatient departments of Obstetrics and Gynecology,BSMMU, Shahbag Dhaka, from April 2020 to March 2021. A total of 80 singleton pregnant women between 18-35 years of age were included in this study in their 24-40 weeks of gestation. Among them, 40 diagnosed women with GDM were considered as the cases and the rest of the 40 matched healthy pregnant women were selected as controls matching for age and gestational age.The overall average Hcy levels in the cases and controls were 5.48±1.3 μmol/L and 4.06±0.98 μmol/L, respectively. Both in the late second trimester and the third-trimester serum Hcy levels were significantly higher in the GDM cases than non-GDM healthy pregnant women (p&lt;0.05). Considering Hcy level of 6.38 μmol/L as the cut-off value, GDM was 4.75 times more likely in pregnant women with elevated serum Hcy level (≥6.38) than those with &lt; 6.38 μmol/L (OR=4.75; 95% CI = 0.941-23.985). There was a significant positive correlation of serum Hcy level with both fasting blood sugar level (r = +0.600, p&lt;0.001) and 2 hrs after 75g glucose level (r = +0.438, p&lt;0.001). Elevated level of serum homocysteine was found associated with GDM. Bangabandhu Sheikh Mujib Med. Coll. J. 2024;3(1):32-37

Saudi women's perspectives on postpartum depression.

Postpartum depression (PPD) is a serious disorder that affects women worldwide, making it a crucial public health concern and one of the most prevalent childbirth complications. Assessing the perspectives of Saudi women towards PPD is essential for addressing the issue and developing effective solutions. This study aimed to assess the knowledge and attitude of Saudi women about PPD in King Abdulaziz Medical City, Western Region. This study employed a descriptive cross-sectional research design and included 226 women recruited through convenience sampling at the Obstetrics and Gynaecology Outpatient Department in King Abdul-Aziz Medical City, Jeddah. Data were collected using a structured questionnaire with 3 main sections: socio-demographic characteristics, knowledge regarding risk factors and symptoms of PPD, and attitude about PPD. The mean score (SD) of the knowledge scale was 31.8 (6.2) with 53.5% of participants having a good level of knowledge about PPD. The mean score (SD) of the attitude scale was 27.1 (2.8) with 47.3% of participants having a positive attitude towards PPD. Significant differences were identified in the knowledge scale, where women who were postgraduates, working in the health sector and unpregnant scored higher in the knowledge scale compared to others (P = .008, P = .02, & P = .008, respectively). The findings of this study indicate that women's knowledge about PPD was generally good; however, many of them held negative attitudes towards PPD. These findings underscore the importance of proper education to improve mental health literacy and address prejudices and negative stereotypes related to PPD among Saudi women.

Qualitative research on the cognition of breastfeeding knowledge in primiparas during pregnancy.

In view of the lack of attention and predictability in postpartum breastfeeding in primiparas, health education on breastfeeding during pregnancy should be carried out to publicize the benefits of breastfeeding. To investigate how well the primiparas during pregnancy are known of breastfeeding knowledge, and to provide a basis for developing health education measures for them. With the adoption of the objective sampling method and the principle of saturation, 10 primiparas in the obstetrics outpatient department of the Hunan Provincial People's Hospital were selected as the study participants. Semi-structured in-depth interviews combined with the observation method were used for data collection. The interview data were analyzed and the theme was refined by Colaizzi's seven-step method. The results of the four themes of the cognition of breastfeeding knowledge among primiparas were as follows: Lack of knowledge and curiosity about breastfeeding in some women, lack of access to correct breastfeeding knowledge, insufficient support from family members for postpartum breastfeeding, and lack of approach to solve problems during breastfeeding among primiparas. Due to the current problems of the cognition of breastfeeding knowledge in primiparas, it was imperative to build a health education model suitable for primiparas to improve this knowledge.

Evaluation of association between periodontitis in pregnant women and preeclampsia

Abstract Background and Objective: Preeclampsia is a maternal disease encountered during the second half of pregnancy. Many risk factors have been implicated in its pathogenesis. Periodontitis may burden pregnant patients systemically with cytokines and endotoxin at the maternal fetal interface leading to endothelium dysfunction. Hence, our objective was to check the association between periodontitis and preeclampsia. Materials and Methods: This observational study was conducted in the outpatient department (OPD) of community health center from March 15, 2022, to December 14, 2022, on 100 patients. Inclusion Criteria: Pregnant women of age group &gt;18 years with informed consent with gestational age between 26 and 36 weeks with Singleton pregnancy. Women with a history of smoking, alcohol and periodontal treatment, multiple pregnancy, and consumption of antibiotics (3 months before study inclusion) were excluded. All eligible candidates in the antenatal clinic in OPD of obstetrics and gynecology were screened by history, obstetrical examination, routine antenatal tests, including urine routine and blood pressure measurement. Subjects were evaluated as per the designed protocol. Fifty preeclamptics were taken as case and 50 non preeclamptic were taken as control. Oral examination was conducted on the patients at the inclusion in the study and followed till delivery. Blood pressure and urine albumin were checked at each visit. Details noted on delivery and outcomes were observed. Results: The risk of preeclampsia in women having periodontitis showed an odds ratio of 3.436 (95% confidence interval: 1.460–8.065; P = 0.006). Conclusion: As the etiology of both events is multifactorial preeclampsia and periodontitis relationship needs wise attention.

A Cross Sectional Study on Prevalence of Bacterial Vaginosis in Preterm and Term Labor

Background: The aim is to examine bacterial vaginosis (BV) in women with preterm and term labor, explore the link between bacterial vaginosis and preterm labor (PTL), and analyze complications for both mother and baby related to bacterial vaginosis. Design: Hospital based cross sectional study. Materials and Method: We had conducted an observational study at Basaveshwara Medical College and Hospital, involving 100 pregnant patients with preterm and term labor (50 patients in each group). Eligible patients attending the Obstetrics and Gynecology Outpatient Department (OBG OPD) and inpatient department will be included. Bacterial vaginosis will be determined using Amsel's criteria, which include evaluating discharge characteristics, vaginal pH, amine odor with KOH test, and presence of clue cells under microscopic examination. Additionally, vaginal swabs will undergo Gram staining. Results: The percentage of patients meeting Amsel's criteria for diagnosing bacterial vaginosis was significantly higher in the preterm labor group compared to the term labor group, with a statistically significant difference. According to Amsel's criteria, the prevalence of bacterial vaginosis was 30% in the preterm labor group and 2% in the term labor group. Conclusion: Bacterial vaginosis is a significant risk factor for preterm labor. Hence, conducting tests for bacterial vaginosis and promptly treating it can help reduce the risk of preterm labor.

Increased Body Mass Index &amp; Waist Circumference are Associated with Female Infertility: A Cross-Sectional Study

Background: The prevalence of obesity and overweight are increasing and has become an epidemic worldwide. Obesity has detrimental influences on all systems, including reproductive health. Obesity can lead to menstrual disturbance, anovulation, miscarriage, pregnancy complications and subfecundity and infertility. This study aimed to investigate the effects of body mass index (BMI) and waist circumference (WC) on infertility in women of childbearing age. Methodology: This was a hospital based cross-sectional observational study comprising hundred (100) infertile women aging 18-35 years in Outpatient Department of Obstetrics &amp; Gynaecology and Endocrinology in Chittagong Medical College Hospital and Department of Biochemistry, Chittagong Medical College, Chattogram. Samples were taken by non-probability consecutive sampling. Important variables in this study were age, BMI, waist circumference and Blood Pressure. Results: Most of the infertile women were 21-30 years. In the study, among the infertile women increased BMI was found in 50% cases and increased waist circumference was found in 76% cases. Conclusion: Overweight and obese patients should be informed about the importance of pre-pregnancy weight reduction and should be encouraged to lose weight before the treatment to reduce the poor obstetrical outcomes due to obesity. Eastern Med Coll J. July 2023; 8 (2):39-42

Frequency of Gestational Diabetes among Women presenting with Premature Rupture of Membranes

OBJECTIVE: To evaluate the frequency of gestational diabetes among women who experience premature rupture of membranes METHODOLOGY: This descriptive cross-sectional study was conducted at the Department of Obstetrics &amp; Gynecology, Mohammad Teaching Hospital Peshawar, from October 2021 to February 2022. One hundred fifty-five patients were selected from the Obstetrics and Gynaecology outpatient department. Women presenting with premature membrane rupture, within the reproductive age of 15-45 years, and with a gestational period beyond 37 weeks were included. Women with a history of failed inductions and those with twin pregnancies confirmed by ultrasound were excluded. A consecutive sampling of 155 females with premature rupture of membranes and screening them for gestational diabetes mellitus. The SPSS (version 22.0) was used for statistical analysis. Categorical variables, including gestational diabetes, parity, and gravidity, were summarized using frequencies and percentages. We conducted post-stratification analysis using the chi-square test, with a significance level set at p &lt; 0.05. RESULTS: The average age of the patients was 27.2±5.7 years, with the majority (49.7%) falling within the age range of up to 25 years. The mean parity was 2.49±1.84. Overall, we diagnosed gestational diabetes mellitus in 24.5% of the patients. CONCLUSION: The presence of gestational diabetes mellitus in cases of premature rupture of membranes is familiar in our population. We recommend conducting further studies to identify risk factors and develop preventive strategies before formulating recommendations for its prevention. KEYWORDS: Diabetes Mellitus, Frequency, Gestational age, Premature birth, Premature Rupture of Membranes, Women

Frequency of Hypovitaminosis D in Obese Adolescent with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders affecting the reproductive age group and is thought to be one of the leading cause of female infertility. Many patients with polycystic ovary syndrome (PCOS) also have features of the metabolic syndrome, including insulin resistance, obesity, and dyslipidemia. Vitamin D affects insulin and glucose metabolism, and a low vitamin D status maybe a risk factor for PCOS. Aim: To determine vitamin D status among the obese adolescent with Polycystic Ovary Syndrome (PCOS) and to compare the vitamin D level among obese and nonobese adolescent with PCOS. Methods: This cross sectional study was done at the out-patient department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University (BSMMU) during November 2017 to October 2018 but the patients enrollment was started after 16 July 2018. The study comprises of 80 adolescent girls diagnosed as PCOS according to Rotterdam criteria, in the age range of 9 to 18 years, out of which 50 obese adolescent girls was considered as group I and 30 non obese adolescent girls was considered as group II. The biochemical parameters measured in the study includes fasting blood sugar, fasting insulin level and serum 25-hydroxy vitamin D level. Serum 25 (OH) D level less than 20 ng/ml was classified as vitamin D deficiency. Results: In this study it was observed that maximum patients were vitamin D deficient in both groups. In group I, 76% and in group II, 60% were vitamin D deficient. Again in group I, 14% and 33.3% in group II were vitamin D insufficient. Only 10% in group I and 6.7% in group II were found to have sufficient level of vitamin D. The mean Vitamin D was found 18.25±5.51 ng/ml in group I and 19.66±5.21 ng/ml in group II. The mean difference of vitamin D level between two groups was statistically not significant. There is a negative significant correlation between vitamin D and BMI which indicates level of vitamin D decreases with increase of BMI of the participants. Conclusion: Vitamin D deficiency was predominant in both groups. Though the difference of vitamin D level was not significant between two groups but the mean level of vitamin D is lower in group I than in group II. There is a negative significant correlation between vitamin D and BMI which indicates that higher BMI levels were associated with lower vitamin D levels.

Sitting on the fence: A qualitative study of perceptions regarding pelvic floor muscle training among pregnant women with urinary incontinence

ObjectivesTo explore the perceptions of pregnant women with urinary incontinence toward pelvic floor muscle training (PFMT). MethodsSemi-structured personal interviews were used to collect data. Pregnant women with urinary incontinence and no contraindications to PFMT were recruited for semi-structured interviews in the Outpatient Department of Obstetrics in a Class A tertiary hospital in Shenzhen from October to November 2021. Purposive sampling was performed, and Braun & Clarke thematic analysis was used for the data analysis. ResultsSixteen pregnant women with urinary incontinence and a mean age of (30.81 ± 3.66) years participated in the interview. “Sitting on the fence” was the predominant theme acquired after analysis. Pregnant women had contradictory attitudes toward PFMT. A total of four themes and nine sub-themes have been extracted: “It is normal and does not really matter” (normalized urinary incontinence, insufficient attention to PFMT); “There is nothing I can do” (insufficient subjective motivations, limitation of objective conditions, lack of social support); “We have to take care of ourselves” (the increasing self-care awareness, emerging autonomous motivation to practice PFMT); “Training should be guaranteed” (requiring the guidance, suggestions, and surveillance of healthcare professionals; requiring the perceptive benefits). ConclusionsThis study reveals varying attitudes towards PFMT among pregnant women with urinary incontinence. To better promote pregnant women’s engagement in PFMT, it is necessary to provide professional guidance, increase self-care awareness, improve social support, and emphasize the benefits of PFMT.

Superb Microvascular Imaging Doppler Technique In The Evaluation Of Ovarian Stromal Vascularity In Women With Polycystic Ovary Syndrome.

To compare the assessment of intra-ovarian stromal vascularity through transabdominal ultrasonography with colour Doppler imaging, power Doppler imaging, colour superb microvascular imaging and monochrome superb microvascular imaging in polycystic ovary syndrome cases. The retrospective cross-sectional study was conducted at the Obstetrics and Gynaecology outpatient department of the Usak Training and Research Hospital, Turkey, from April 11 to June 18, 2018, and comprised grayscale colour Doppler imaging, power Doppler imaging, colour superb microvascular imaging and monochrome superb microvascular imaging of women with polycystic ovary syndrome. The recorded video images were evaluated by three radiologists and rated through consensus decision. Mean values for age, body mass index, follicle stimulating hormone and luteinizing hormone levels, luteinizing hormone-follicle stimulating hormone ratio, Ferriman Gallwey score, and mean ovarian volume of the subjects were evaluated. Data was analysed using Number Cruncher Statistical System. Of the 54 women evaluated, data of 42(77.8%) was included. There were a total of 83 ovaries, as the left ovary of 1(1.2%) patient was not visible. The mean age and body mass index were 24.02±5.8 years and 25.08±4.5kg/m2. Mean follicle stimulating hormone and luteinizing hormone levels were 5.51±1.91 and 7.91±6.13m IU/mL. Luteinizing hormone/follicle stimulating hormone ratio and Ferriman Gallwey score were 1.4±0.8 and 8.67 ±6.94, respectively. The mean ovarian volume was 12.2±3.43 cm3. The detection of vascularity was colour Doppler imaging 0.72±0.97, power Doppler imaging 0.96±1.08, colour superb microvascular imaging 2.47±1.25, and monochrome superb microvascular imaging 2.75±1.31. The techniques were significant for superb microvascular imaging Doppler than conventional Doppler (p<0.001). Hyper- ovarian stromal vascularity, like a 'stellate' sign, was detected in 17(20.5%) of the total 83 ovaries analysed. Transabdominal ultrasonography-colour superb microvascular imaging was found to be more effective in detecting ovarian vascularity than conventional Doppler technique in women with polycystic ovary syndrome.

Perceptions and experiences of exercise among pregnant women

IntroductionThough exercise during pregnancy can yield important maternal benefits, most pregnant women in China do less aerobic exercise than is currently recommended. This qualitative study aimed to explore the perceptions and experiences of physical exercise among pregnant women and to identify perceived barriers to and facilitators of exercise participation. MethodsPurposive sampling was used to recruit 40 pregnant women attending prenatal visits at an obstetrics outpatient department of a tertiary general hospital in Southern China. Individual semi-structured telephone interviews were conducted with the verbatim transcripts analyzed through content analysis. ResultsThree main themes emerged from the data: perceptions and patterns of exercise; concerns and hesitations about participating in exercise; and determinants of adoption and maintenance of exercise participation. Though pregnant women recognised their need for physical exercise instruction, their demands remained unmet due to a combination of factors such as lack of knowledge, confidence, and support, and concerns about safety. DiscussionThe findings of this study suggest that the provision of tailored exercise programs for pregnant women, which include education, reassurance, motivational strategies, and lay and professional support, may help improve knowledge, allay concerns, boost confidence, and bolster support when doing physical exercise.

Assessment of Contraceptive Usage Patterns and Associated Factors among Women in Bangladesh: A Hospital-Based Observational Study

Background: The use of contraceptives is crucial in managing family size, improving maternal health, and enhancing socio-economic development. Despite progress in promoting contraceptive use, challenges persist in countries like Bangladesh, where socio-cultural dynamics can affect the uptake and usage patterns. This study aimed to assess contraceptive usage patterns and associated factors among women attending a hospital in Bangladesh. Material &amp; Methods: This prospective observational study was conducted at the Outpatient Department of Obstetrics and Gynecology, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh, from January 2021 to December 2022. The study included 150 women of reproductive age (18-45 years) who visited the hospital for gynecological problems or regular check-ups. Data was collected through structured interviews using validated questionnaires assessing knowledge and usage of contraceptive methods. Descriptive statistics and Chi-square tests were used for data analysis. Results: Among the participants, 66.00% reported regular contraceptive use, 10.67% reported irregular usage, and 23.33% stated they were not using contraception. Oral contraceptive pills were the most common method (43.48%). There was a significant association between contraceptive usage patterns and education level, age group, marital status, and number of children. In contrast, residence did not significantly associate with contraceptive practice. Conclusion: Despite high awareness levels, there exists a gap between knowledge and consistent contraceptive use. Education level, age, marital status, and number of children significantly influence contraceptive usage patterns. This study highlights the importance of integrating these socio-demographic factors in the planning and implementation of family planning policies to promote effective contraceptive use in Bangladesh. Future research should investigate the reasons behind irregular or non-use of contraceptives among informed women and devise strategies to bridge the knowledge-practice gap.

The cytological pattern of cervical papanicolaou smear in a tertiary hospital of India

Background: Cervical cancer continues to be listed among the top gynecologic cancers worldwide. According to current data, it is ranked fourteenth among all cancers and fourth-ranked cancer among women worldwide. In India alone 1,30,000 new cases occur with the death toll of 70,000 per year. A “PAP’ test should be performed during the second half of the menstrual cycle (Day 14). The patient is placed in lithotomy position and the cervix is visualized by means of a speculum. The smaller end of the Ayre’s spatula is introduced through the external os and the squamocolumnar junction is scraped by rotating the spatula to 360°. Aims and Objectives: The objective of the study is to evaluate the use of the Pap smear screening method for detection of precancerous lesions. Cervical cancer accounts for 15% of all cancers in females. If treated or detected earlier, cervical cancer can be prevented. Materials and Methods: This study was done on 1000 patients during reproductive and later age groups (postmenopausal), attending Obstetric and Gynaecological Outpatient Department of Panna Dhai Hospital associated with RNTMC, Udaipur during the period of November 2012–April 2014 with history of white discharge per vagina, bleeding per vagina, pain in lower abdomen and post coital bleeding. Results: Most of the smears (90.1%) were NILM and 9.9% of smears showed cytological abnormality. Majority 834 (83.4%) of smears were inflammatory, Bacterial vaginosis was seen in 119 cases (11.9%), Candidiasis in 78 cases (7.8%), Trichomoniasis in 35 cases (3.5%), Atrophic vaginitis in 4 cases (0.4%) and Radiation changes in 4 cases (0.4%). There were 99 samples reported as having epithelial cell abnormality. Out of which 75 were LSIL, 14 were high grade squamous intraepithelial, 5 were atypical squamous cells (ASC)-US, 1 was ASC-H and 4 were squamous cell carcinoma. Conclusion: Due to high sensitivity, specificity and accuracy found in this study Pap test is proved to be highly useful to detect precancerous and cancerous lesions of cervix. From the above facts, it can be concluded that early diagnosis and prompt specific treatment of preinvasive or early stages of the disease (mainly in high risk women), reduces the prevalence of invasive carcinoma of uterine cervix.

The Pregnancy Outcome in Women with Polycystic Ovary Syndrome

Background: In women of reproductive age, polycystic ovarian syndrome (PCOS) is a prevalent endocrine condition. Menstrual irregularities (oligomenorrhea or amenorrhea), hirsutism, persistent acne, androgen-dependent alopecia, abdominal obesity, hypertension, and infertility are all clinical signs of PCOS.Objective: To assess the success of pregnancy in patients with polycystic ovary syndrome.Materials and Methods: This observational cross-sectional study was carried out in the Department of Obstetrics and Gynaecology at Khwaja Yunus Ali Medical College and Hospital, Enayetpur, Sirajganj, Bangladesh from June 2020 to May 2022 for a period of two years. Women diagnosed with PCOS were willing to participate in our study were recruited from obstetrics Out patient Department (OPD) and antenatal ward of Department of Obstetrics and Gynaecology at Khwaja Yunus Ali Medical College and Hospital. After obtaining an informed consent from them, a detailed interview schedule containing socio- demographic details, menstrual/marital/ obstetric/past/personal/ family history was taken.Results: Concerning complications Preeclampsia was found in 5 (9.1%) of the PCOS patients but not in the non-PCOS patients. The differences in gestational age and mode of birth between the two groups were not statistically significant (p&gt;0.05). Perinatal outcome: 21 (39.6%) PCOS patients were admitted to the Neonatal Intensive Care Unit (NICU), compared to 11 (20.0%) non-PCOS patients. Which of the two groups was statistically significant (p&lt;0.05).Conclusion: The present study suggested that preeclampsia is a relatively common condition, and complications such gestational hyperglycemia, gestational hypertension, and preeclampsia were frequent in the PCOS group. In comparison to the non-PCOS group, the PCOS group had considerably greater rates of low birth weight and NICU admission. KYAMC Journal Vol. 14, No. 01, April 2023: 30-34

Uterine artery Doppler screening in 18 to 24 weeks of pregnancy for prediction of adverse maternal outcome

Background: Uterine artery Doppler velocimetry (UADV) analysis has been extensively studied in the second trimester of pregnancy as a predictive investigation for the future development of adverse feto-maternal outcome. This study was designed to assess the association between findings of uterine artery Doppler velocimetry with maternal outcome. Methods: This was a prospective observational study among the pregnant women attending the inpatient and outpatient departments of Obstetrics and Gynecology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Segunbagicha, Dhaka, from July 2021 to December 2021. A total of 31 women with singleton pregnancy were enrolled in this study at their 18-24 weeks of gestation. After obtaining informed written consent, data were collected from patients on variables of interest using a semistructured questionnaire. All the respondents underwent uterine artery Doppler velocimetry at 18 to and 24 weeks of gestation and were followed up to observe its relationship with feto-maternal outcome. Descriptive and inferential analyses were done using SPSS v.21. Results: More than half (51.6%) of the subjects belonged to 30 years and above. The mean age was found 29.71±4.8 years with ranged from 21 to 40 years. Most (96.8%) of the subjects had diabetes mellitus and only 32.3% subjects had hypertension. More than half (54.8%) had adequate diastolic flow and 32.3% subjects had diastolic notch. Majority (64.3%) of the respondents with decreased diastolic flow had preeclampsia. Majority (70.0%) of the respondents with diastolic notch also developed preeclampsia. All these findings were statistically significant (p&lt;0.05). Conclusion: In conclusion, pregnant women who have normal UADV finding at their 2nd trimester possess less chance of development of adverse maternal outcome. BIRDEM Med J 2023; 13(2): 92-97

Knowledge, Attitude, and Practices of Pregnant Women Towards Antenatal Care in Tertiary Care Hospital Somalia: A Prospective Study

Introduction: All women, regardless of their pregnancies, deserve high-quality maternal services during pregnancy, delivery, and afterward. This study aims to evaluate the knowledge and attitude of pregnant women toward antenatal care. Materials and Methods: A prospective study was carried out among pregnant women attending at obstetrics outpatient department of Mogadishu Somali Turkish Training and Research Hospital. The sample was obtained using random sampling methods. In addition, information was gathered using a structured interview schedule between August and October 2022. Results: The majority (63.3%) of respondents were aged between 20 and 24, while 21% were between the ages of 25 and 29, and 8% were between the ages of 30 and 34. One hundred sixty-five pregnant women had primary school education, 31% had secondary education, 15% had a university education, and 11% were illiterate. Only 252 (63.3%) correctly identified the first prenatal check-up within three months. Conclusion: According to the findings, most of the study's participants had a high level of knowledge and good practices, and most had a favorable opinion about ANC. The Federal Ministry of Health's public health department should strengthen national health education programs to promote antenatal care.

PREVALENCE AND RISK FACTORS OF URINARY INCONTINENCE AMONG WOMEN

Aim: To identify prevalence of different types of urinary incontinence and risk factors associated with them. Study Design: This was a cross sectional study conducted between March 2021 to March 2022 at outpatient department of Obstetrics and Gynaecology at SMS medical college, Jaipur. 100 women with complaint of leakage of urine were enrolled in study and data was collected as face to face interview with questionnaires. The data is expressed as mean, median, standard deviation. P values are calculated and &lt;0.05 are considered signicant. Results: Majority of women had stress urinary incontinence (48%) followed by urge and mixed incontinence (30%,22% respectively). Majority of women were housewives (83.3%). Socioeconomic status, BMI , education status (p value- 0.001, 0.024, 0.004) were found to be signicantly associated with urinary incontinence. Age, Duration, High BMI and Higher parity was signicantly associated with severity of urinary leakage. History of UTI/ cystitis has been signicantly associated with urge incontinence (p value of 0.021) and women with history of constipation has been signicantly associated with stress incontinence (p value of 0.01). Medical disorders did not show any signicant association in the study. Conclusion: Stress urinary incontinenec is found to have the highest prevlance. Age, BMI, parity, educational status, occupation and previous infections and surgical history are various risk factors for same