Poor In Utero Growth, and Reduced β-Cell Compensation and High Fasting Glucose From Childhood, Are Harbingers of Glucose Intolerance in Young Indians.

Objective: India is a double world capital of early-life undernutrition and type 2 diabetes. We aimed to characterize life course growth and metabolic trajectories in those developing glucose intolerance as young adults in the Pune Maternal Nutrition Study (PMNS).

Research Design And Methods: PMNS is a community-based intergenerational birth cohort established in 1993, with serial information on parents and children through pregnancy, childhood, and adolescence.

Calibrated delivery drape versus indirect gravimetric technique for the measurement of blood loss after delivery: a randomized trial.

Background: Trials of interventions for PPH prevention and treatment rely on different measurement methods for the quantification of blood loss and identification of PPH. This study's objective was to compare measures of blood loss obtained from two different measurement protocols frequently used in studies.

Methods: Nine hundred women presenting for vaginal delivery were randomized to a direct method (a calibrated delivery drape) or an indirect method (a shallow bedpan placed below the buttocks and weighing the collected blood and blood-soaked gauze/pads).

Patterns of fetal growth in a rural Indian cohort and comparison with a Western European population: data from the Pune maternal nutrition study.

Objective: The purpose of this study was to describe fetal size on sonography in a rural Indian population and compare it with those in European and urban Indian populations. Methods. Participants were from the Pune Maternal Nutrition Study of India.

Understanding women's experiences with medical abortion: In-depth interviews with women in two Indian clinics.

We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedicalisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in-depth interview guide. While women appreciated the non-invasiveness of medical abortion, other factors influencing method selection were family support and distance from the facility.

Phase II clinical trial with Praneem polyherbal tablets for assessment of their efficacy in symptomatic women with abnormal vaginal discharge (an ICMR task force study).

Abnormal vaginal discharge syndrome (AVDS) is a commonly observed gynaecological complaint for which women seek medical attention. The present study was conducted in six Indian Council of Medical Research centres with Praneem polyherbal tablets (PPT), to determine their efficacy in the treatment of symptomatic women with AVDS. Data are given on 141 subjects investigated.

Vitamin B12 and folate concentrations during pregnancy and insulin resistance in the offspring: the Pune Maternal Nutrition Study.

Aims/hypothesis: Raised maternal plasma total homocysteine (tHcy) concentrations predict small size at birth, which is a risk factor for type 2 diabetes mellitus. We studied the association between maternal vitamin B12, folate and tHcy status during pregnancy, and offspring adiposity and insulin resistance at 6 years.

Methods: In the Pune Maternal Nutrition Study we studied 700 consecutive eligible pregnant women in six villages.

Mifepristone followed in 24 hours to 48 hours by misoprostol for late first-trimester abortion.

Objective: To investigate the efficacy of mifepristone and misoprostol for the termination of pregnancies in the late first trimester.

Methods: This was a prospective study of 321 women seeking termination of pregnancy with gestations from 64 days to 84 days (+/-3 days) by vaginal ultrasonography. Women were enrolled at three sites: University of Rochester Reproductive Health Program in Rochester, New York; Hung Vuong Hospital in Ho Chi Minh City, Vietnam; and K.

Are two doses of misoprostol after mifepristone for early abortion better than one?

Objective: The objective of this study was to determine if a repeat dose of misoprostol following mifepristone or a single dose of misoprostol increases the efficacy of medical termination of pregnancy.

Design: Randomised, placebo controlled trial.

Setting: K.

Characteristics of gestational diabetic mothers and their babies in an Indian diabetes clinic.

Aims And Objectives: To compare clinical and metabolic features of mothers with gestational diabetes (GDM) and their offspring with those in non-diabetic pregnancies at the King Edward Memorial Hospital, Pune, India.

Materials And Methods: Antenatal information was obtained from hospital records. GDM was diagnosed by 75 g OGTT (Oral Glucose Tolerance Test) in clinically high-risk women.

Infertility: a label of choice in the case of sexually dysfunctional couples.

Objectives: In Indian society infertility and sexual dysfunction are stigmatized characteristics. The aim of the study was to explore which label couples who have both complaints, prefer to describe their situation, and whether gender differ occur in this preference.

Methods: A total of 40 couples - all clients of the reproductive health clinic of the King Edward Memorial Hospital in Pune because of problems with infertility and sexual dysfunction - participated in this study.

Increasing maternal parity predicts neonatal adiposity: Pune Maternal Nutrition Study.

Objective: This study was undertaken to study the effect of parity on maternal and neonatal characteristics.

Study Design: Maternal anthropometry, diet, micronutrient status, biochemistry, and physical activity were measured during pregnancy and detailed neonatal size recorded in 770 pregnancies in rural Maharashtra, India.

Results: Increasing parity was associated with larger offspring birth weight, skinfold thicknesses, and abdominal circumference, but not head circumference and length.

Misoprostol alone for early abortion: an evaluation of seven potential regimens.

Introduction: A growing body of literature has shown that misoprostol alone could be effective for early medical abortion. We evaluated seven potential regimens in women up to 56 days of gestation in order to potentially identify an optimal regimen.

Methods: In phase I of the study, women requesting early abortion were randomized to one of three misoprostol regimens (4x400 microg po every 3 h, 2x800 microg po every 6 h, 1x600 pv microg); in phase II, women were randomized to one of two regimens (2x800 microg po every 3 h, 1x800 pv microg).

Maternal total homocysteine concentration and neonatal size in India.

The smallness of Indian babies is ascribed to small maternal size and their chronic under nutrition. Micronutrient nutrition of the mother may be particularly important. We investigated the relationship between maternal circulating concentrations of total homocysteine (tHcy), vitamin B12 and folate and offspring size at birth.

Accounting for time: insights from a life-table analysis of the efficacy of medical abortion.

Objective: Previously published analyses have ignored the temporal nature of medical abortion and calculated effectiveness as the proportion of abortions that succeed. By using life tables, we incorporate the important element of time to produce unbiased efficacy rates as well as afford insight into the medical abortion process.

Study Design: Using data on 6568 women from 6 previously published mifepristone-misoprostol medical abortion studies, we generated multidecrement life table efficacy curves and evaluated the cumulative probability of successful medical abortion.

Differences in efficacy, differences in providers: results from a hazard analysis of medical abortion.

Sample sizes of even the largest medical abortion trials are generally not adequate to provide an understanding of how well the regimen works for subgroups of women, particularly when controlling for factors known to influence efficacy, such as gestational age. By pooling data from four previously published studies of medical abortion and using hazard analyses, we can undertake such an investigation. We find that women with lower gestational ages, women younger than 23 years of age, women with more than 12 years of education and women with no previous induced abortion experience were more likely to experience a successful medical abortion.

Neonatal anthropometry: the thin-fat Indian baby. The Pune Maternal Nutrition Study.

Objective: To examine body size and fat measurements of babies born in rural India and compare them with white Caucasian babies born in an industrialised country.

Design: Community-based observational study in rural India, and comparison with data from an earlier study in the UK, measured using similar methods.

Subjects: A total of 631 term babies born in six rural villages, near the city of Pune, Maharashtra, India, and 338 term babies born in the Princess Anne Hospital, Southampton, UK.

Mifepristone-misoprostol abortion: a trial in rural and urban Maharashtra, India.

As several important policy questions remain regarding the use of medical abortion in developing countries, we investigated the safety, efficacy, and acceptability of mifepristone-misoprostol abortion in the outpatient family planning departments of two urban hospitals and one rural hospital in India. Nine-hundred women (with gestations of < or =63 days in the urban sites and < or =56 days in the rural site) received 600 mg mifepristone followed 48 h later by 400 microg oral misoprostol in the clinic. Four point four percent or fewer urban women and 1.

Emergency contraception: randomized comparison of advance provision and information only.

Objective: To determine whether multiple courses of emergency contraceptive therapy supplied in advance of need would tempt women using barrier methods to take risks with their more effective ongoing contraceptive methods.

Methods: We randomly assigned 411 condom users attending an urban family planning clinic in Pune, India, to receive either information about emergency contraception along with three courses of therapy to keep in case of need, or to receive only information, including that about the locations where they could obtain emergency contraception if needed. For up to 1 year, women returned quarterly for follow-up, answering questions about unprotected intercourse, emergency contraceptive use, pregnancies, sexually transmitted infections, and acceptability.

Mifepristone abortion outside the urban research hospital setting in India.

Medical abortion holds great promise in less-developed countries, where abortion morbidity and mortality remain high. We tested the French mifepristone-misoprostol regimen in two urban outpatient family-planning clinics (n=600) and a rural hospital (n=300) in India. 4% of urban women and 1% of rural women were lost to follow-up.

Accuracy of assessment of pregnancy duration by women seeking early abortions.

Background: Advances in medical abortion might allow women seeking early abortions to terminate their pregnancies safely and effectively without medical supervision. We investigated whether such women can calculate pregnancy duration accurately, a key step in unsupervised use.

Methods: 422 women seeking first-trimester abortions in two clinics (Pune, India, and Atlanta, USA) used a simple worksheet and calendar to calculate the duration of gestation from the date of last menstrual period (LMP) and/or of unprotected intercourse.

Syndromic management of vaginal discharge among women in a reproductive health clinic in India.

Objectives: To examine the performance of the syndromic approach in the management of vaginal discharge among women attending a reproductive health clinic in New Delhi, India.

Methods: Women who sought services from the clinic and who had a complaint of vaginal discharge were interviewed, underwent a pelvic examination, and provided samples for laboratory investigations of bacterial vaginosis, candidiasis, syphilis, trichomoniasis, and Chlamydia trachomatis and Neisseria gonorrhoeae infections. Data analysis focused on the prevalence of infection and on the performance of the algorithm recommended by the national authorities for the management of vaginal discharge.

Early medical abortion in India: three studies and their implications for abortion services.

Although legal in India, abortion is frequently performed under unsafe or undesirable conditions. Moreover, the advancements required to make surgical abortion safe in India appear insurmountable in the near future. Because it requires a less extensive infrastructure than surgical abortion, medical abortion offers great potential for improving abortion access and safety now.

Misoprostol alone--a new method of medical abortion?

Misoprostol shows promise for early termination of pregnancy. The drug is widely available, inexpensive, and easy to administer. Current evidence on the efficacy of potential regimens for early abortion, though, is hard to decipher and often contradictory.

Low midpregnancy placental volume in rural Indian women: A cause for low birth weight?

Objective: We sought to study midpregnancy placental volume in rural Indian women, its maternal determinants, and its relationship to neonatal size.

Study Design: We performed a prospective community-based study of maternal nutrition and fetal growth in 6 villages near the city of Pune. Measurements included midpregnancy placental volume determined by means of ultrasonography at 15 to 18 weeks' gestation, maternal anthropometric measurements before and during pregnancy, and maternal blood pressure and biochemical parameters during pregnancy.