Splenic artery aneurysm and infarction during pregnancy from infective endocarditis.

Rheumatic heart disease (RHD) remains the leading cardiac problem affecting pregnant women, especially in low- to middle-income countries. In nearly one-third of the cases, it is detected during pregnancy when they present with complications. Infective endocarditis (IE) in pregnancy is rare, with an incidence of 1 in 100 000 pregnancies, and carries high maternal and fetal morbidity and mortality.

Impact of social determinants of health on progression from potentially life-threatening complications to near miss events and death during pregnancy and post partum in a middle-income setting: an observational study.

Objective: To assess the potential associations between social determinants of health (SDH) and severe maternal outcomes (SMO), to better understand the social structural framework and the contributory, non-clinical mechanisms associated with SMO.

Study Design: Prospective observational study.

Study Setting: Tertiary referral centre in south-eastern region of India.

Comparison of Efficacy of Vaginal Misoprostol versus a Synthetic Osmotic Dilator (Dilapan-S) for Cervical Preparation before Operative Hysteroscopy: A Randomized Controlled Study.

Objectives: To compare the need for mechanical cervical dilatation following vaginal misoprostol or synthetic osmotic dilator (Dilapan-S) usage for cervical preparation before operative hysteroscopy.

Materials And Methods: Fifty-five premenopausal women scheduled for operative hysteroscopic procedures with a 26 Fr resectoscope were included in this randomized, controlled clinical trial. After randomization, either 400 μg of vaginal misoprostol or intracervical synthetic osmotic dilator (Dilapan-S) was inserted 12 h before operative hysteroscopy.

Diagnostic challenges in cerebral tuberculoma presenting with seizures in pregnancy.

Tuberculoma is an uncommon presentation of tuberculosis and is found in regions with a high prevalence of tuberculosis. This is rarely diagnosed during pregnancy. The presentation can mimic other etiologies such as eclampsia or cerebral venous sinus thrombosis so the diagnosis can be challenging, particularly when presenting with seizures in pregnancy.

Impact of near-miss event during pregnancy and childbirth on maternal health at 12 months.

Objective: To assess the impact of maternal near-miss on late maternal death and the prevalence of hypertension or chronic kidney disease (CKD) and mental health problems at 12 months of follow up.

Methods: This prospective cohort study was conducted in a tertiary hospital in the southeastern region of India from May 2018 to August 2019, enrolling those with maternal near-miss and with follow up for 12 months. The primary outcomes were incidence of late maternal deaths and prevalence of hypertension and CKD during follow up.

Correlation between hypertensive retinopathy and fetal outcomes in patients with preeclampsia in a tertiary care hospital: A prospective cohort study.

Purpose: To study the effect of increasing grades of hypertensive retinopathy (HTR) on neonatal outcomes among preeclamptic women and assess the various maternal risk factors for HTR.

Methods: A prospective cohort study was conducted on 258 preeclamptic women. The systolic and diastolic blood pressure (SBP and DBP), liver, and renal function parameters were collected besides basic demographic details.

External validation of the Maternal Severity Index for predicting maternal death following potentially life-threatening complications during pregnancy and childbirth: a single-centre, prospective observational study.

Objectives: To perform an external validation to assess the usefulness of the Maternal Severity Index (MSI) in predicting maternal death among women with potentially life-threatening complications during pregnancy or childbirth.

Design: Prospective observational study.

Setting: A tertiary referral centre in southeastern India.

Indicators for maternal near miss: an observational study, India.

Objective: To compare the incidence of maternal near miss using the World Health Organization (WHO) near-miss tool and six other criteria sets, including criteria designed for low-resource settings or specifically for India.

Methods: In a cohort study we used WHO severity indicators to identify women with potentially life-threatening conditions during pregnancy or childbirth admitted to a referral hospital in Puducherry, India, from May 2018 to April 2021. We analysed sociodemographic, clinical and laboratory data for each woman and calculated the incidence of maternal near miss and other process indicators for each set of criteria.

Maternal and perinatal outcome in pregnancies complicated with portal hypertension: a systematic review and meta-analysis.

Background: Portal hypertension is secondary to either cirrhotic or non-cirrhotic causes, and complicating pregnancy poses a challenge to the treating team. A systematic review was performed to determine maternal and perinatal outcomes in women with portal hypertension. Outcomes were compared among those with cirrhotic (CPH) with non-cirrhotic portal hypertension (NCPH) as well as non-cirrhotic portal fibrosis (NCPF) with extra-hepatic portal vein obstruction (EHPVO).

Risk factors associated with unplanned caesarean section in women with placenta previa: a cohort study.

Unplanned/emergency caesarean section (CS) can lead to an increased risk of increased risk of adverse maternal and perinatal outcomes. This prospective observational study was conducted in a tertiary centre in South India to determine the factors associated with increased risk of unplanned/emergency CS among women with placenta previa (PP). Primary outcome was the unplanned CS defined as emergency CS performed, prior to the scheduled date of delivery, for profuse vaginal bleeding or onset of labour pains.

Serum biomarkers of maternal morbidity and adverse outcome in severe pre-eclampsia.

Objective: To evaluate the association of maternal serum biomarkers of myocardial damage, oxidative stress and angiogenic imbalance with maternal adverse outcomes in women with severe pre-eclampsia.

Methods: This was a prospective cohort study, where maternal serum biomarkers were evaluated in women admitted with severe pre-eclampsia to a tertiary care centre between March 2019 and February 2020. Serum markers included brain naturetic peptide (BNP), cardiac troponin-T (cTnT), cystatin-C (cys-C), soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), Total Anti-Oxidant status (TAO) and malondialdehyde (MAO).

Migration of Ventriculoperitoneal Shunt to the Uterus in a Child: A Case Report.

Background: A ventriculoperitoneal shunt (VPS) is usually placed inside the peritoneal cavity for cerebrospinal fluid drainage. Rarely, it can migrate to various pelvic visceral organs. Inside the pelvis, the distal end of the shunt can perforate anywhere from the uterus or adnexa to the vulva, and migration through the uterus is extremely rare.

Diagnostic Accuracy of Hysteroscopic Scoring System in Predicting Endometrial Malignancy and Atypical Endometrial Hyperplasia.

Aims And Objectives: The aim of this study was to determine the diagnostic accuracy of a hysteroscopic scoring system in predicting endometrial cancer and endometrial hyperplasia with atypia.

Materials And Methods: This is a prospective study involving 95 peri and postmenopausal women with abnormal uterine bleeding who underwent hysteroscopic-guided endometrial biopsy. After the calculation of hysteroscopic score, biopsy was obtained and sent for histopathological examination.

Management dilemmas in pineoblastoma recurrence diagnosed during pregnancy.

Pineoblastoma is an extremely rare intracranial neoplasm, with increased risk of craniospinal metastasis. There is only one case reported in the literature who presented during pregnancy. Described here is a woman who presented at five months of gestation with recurrence of pineoblastoma, who had previously defaulted adjuvant therapy following surgical decompression.

Comparison of Bipolar Ball Endometrial Ablation and Transcervical Resection of the Endometrium in the Treatment of Heavy Menstrual Bleeding: A Randomized Clinical Trial.

Objectives: To compare the operative time, effectiveness, and patient satisfaction between ball endometrial ablation and transcervical resection of the endometrium (TCRE) using a bipolar resectoscope.

Materials And Methods: Forty-four women with heavy menstrual bleeding who were unresponsive to at least 3 months' medical management were included in this randomized, controlled clinical trial. After randomization, patients underwent either TCRE or ball endometrial ablation using a bipolar resectoscope.

Postpartum depression and its risk factors in women with a potentially life-threatening complication.

Objective: To assess the incidence of postpartum depression (PPD) and its risk factors in women with potentially life-threatening complications.

Methods: Eight hundred and ninety women admitted to a tertiary center in South India with potentially life-threatening complications were recruited for the study. Within seven days of delivery, women underwent mental health assessments using the EPDS and PHQ-9 scale.

Influence of maternal and perinatal characteristics on risk of postpartum chronic hypertension after pre-eclampsia.

Objective: To assess the prevalence of new-onset postpartum chronic hypertension (PPCH) after pre-eclampsia and to determine the factors are associated with it.

Methods: This study was conducted in a tertiary center in south India, between June 2018 and February 2019, consisting of pre-eclamptic women who were recruited as part of an ongoing cohort and had completed at least 3 months of postpartum follow-up. Demographic, medical, and laboratory details were collected.

Maternal-fetal outcome in pregnancies complicated with non-cirrhotic portal hypertension: experience from a Tertiary Centre in South India.

Objective: To assess the maternal and perinatal outcomes of pregnant women with non-cirrhotic portal hypertension (NCPH).

Methods: This was an observational study done by retrieving the records of pregnant women with non-cirrhotic portal hypertension admitted to a tertiary hospital in South India, over a 9-year study period. Data regarding the clinical course, complications during pregnancy, labor, and delivery details were reviewed.

Referral chain of patients with obstetric emergency from primary care to tertiary care: A gap analysis.

Background: The referral system plays a crucial role in antenatal care and childbearing by providing access to emergency obstetric care. Excess referral from primary care and bypassing secondary levels of care leads to overcrowding of high risk and normal mothers in tertiary centers. Hence, this study aims to assess the gaps in the referral of patients with obstetric emergency from primary care to tertiary care.

Efficacy and safety of Tramadol as an analgesic in women undergoing vaginoscopic hysteroscopy: a randomized placebo-controlled trial.

Pain or discomfort during the hysteroscopy remains a challenge even after the introduction of small calibre instruments and vaginoscopic techniques. Tramadol, a centrally acting analgesic, is one among the medications used to reduce pain; however, the experience with its use in the vaginoscopic technique is limited. This was a randomised double-blind placebo-controlled trial conducted to study the effectiveness of oral Tramadol as an analgesic in 100 women undergoing diagnostic vaginoscopic hysteroscopy.

Comparison of 'push method' with 'Patwardhan's method' on maternal and perinatal outcomes in women undergoing caesarean section in second stage.

A deeply impacted foetal head in a second stage caesarean section is associated with an increased risk of maternal and neonatal complications. For the present study, we compared the maternal and neonatal outcomes during the use of the 'Push method' and of 'Patwardhan's method' for a foetal head delivery in a second-stage caesarean section. This was a retrospective observational study involving 298 women who underwent a second stage caesarean section with a foetal head at or below the level of their ischial spines and was conducted in a tertiary teaching hospital in South India.

Addition of power Doppler to grey scale transvaginal ultrasonography for improving the prediction of endometrial pathology in perimenopausal women with abnormal uterine bleeding.

Background & Objectives: Transvaginal ultrasonography (TVS) is a non-invasive procedure and can be used as a screening tool among women with abnormal uterine bleeding (AUB). Power Doppler is useful in depicting the vascular architecture better than the conventional Doppler. Hence, this study was conducted to evaluate whether addition of power Doppler to grey scale TVS can replace invasive hysteroscopy for the prediction of endometrial pathology in perimenopausal women with AUB.

Effect of cervical priming with misoprostol on cervical entry in women undergoing vaginoscopic hysteroscopy for evaluation of abnormal uterine bleeding: a randomized controlled trial.

Objective: To study the effect of cervical priming with misoprostol on cervical entry in women undergoing diagnostic hysteroscopy for evaluation of abnormal uterine bleeding.

Methods: Randomized controlled trial conducted in teaching hospital and tertiary referral center on 122 women requiring diagnostic hysteroscopy for evaluation of abnormal uterine bleeding. Women were randomized into two equal groups (n = 122).