Endocervicoscopy with Office Hysteroscope for Complete Visualization of Transformation Zone in Cases of Invisible Squamocolumnar Junction on Colposcopy.

Aim: To evaluate the role of endocervicoscopy for the visualization of the T3 transformation zone (TZ) on colposcopy.

Materials And Methods: Forty patients with either abnormal Pap smear or positive VIA-VILI and T3 TZ on colposcopy were recruited from the colposcopy clinic and subjected to endocervicoscopy with a 4-mm office hysteroscope. The view of the endocervical canal was recorded before and after the application of 5% acetic acid and the squamocolumnar junction was identified in its entirety.

Comparison of Mifepristone Followed by Misoprostol with Misoprostol Alone for Treatment of Early Pregnancy Failure: A Randomized Double-Blind Placebo-Controlled Trial.

Objective: To compare the efficacy and safety of mifepristone followed by misoprostol with misoprostol alone in the management of early pregnancy failure (EPF).

Study Design: A randomized double-blind placebo-controlled clinical trial.

Methods: Ninety-two women with EPF ≤12 weeks were recruited and randomly allocated to receive either mifepristone 200 mg ( = 46) or placebo ( = 46).

Evaluation of sonographic endometrial patterns and endometrial thickness as predictors of ectopic pregnancy.

Objective: To evaluate whether endometrial patterns and thickness could be used for the prediction of ectopic pregnancy (EP).

Methods: A prospective study was conducted in a center in India between October 2007 and December 2008. It included 100 women with an early pregnancy confirmed by urine pregnancy testing but for whom an intrauterine gestational sac was not visualized on transvaginal ultrasonography (TVS).

A hospital-based study of intimate partner violence during pregnancy.

Objective: To determine the prevalence and types of intimate partner violence (IPV) during pregnancy, factors linked with IPV, and effects of IPV on maternal-fetal outcomes.

Methods: In a prospective observational study at a tertiary care hospital in Delhi, India, 400 women at 20-28 weeks of pregnancy were screened for IPV between December 2013 and April 2015. The women completed a detailed questionnaire and were followed up until delivery.

Evaluation of maternal early obstetric warning system (MEOWS chart) as a predictor of obstetric morbidity: a prospective observational study.

Objectives: Maternal Early Obstetric Warning System (MEOWS) chart adopted from CEMACH 2003-2005 report is based on the principle that abnormalities in physiological parameters precede critical illness. The 'track and trigger' of physiological parameters on this chart can aid in recognition of maternal morbidity at an early stage, ultimately halting the cascade of severe maternal morbidity and mortality. The objectives of our study were to evaluate MEOWS chart as a bedside screening tool for predicting obstetric morbidity and to correlate each physiological parameter individually with obstetric morbidity.

Comparison of Keyes Punch Biopsy Instrument with Cervical Punch Biopsy Forceps for Diagnosing Cervical Lesions.

Objective: To assess the feasibility and efficacy of Keyes punch biopsy instrument (KP) in diagnosing cervical lesions and compare it with cervical punch biopsy forceps (CP).

Methods: 75 women having satisfactory colposcopy with abnormal transformation zone were included and paired colposcopic directed biopsies were taken using KP followed by CP from the same target area.

Results: It was feasible in all cases to take cervical biopsy with KP after increasing its effective length.

Predictors and outcome of obstetric admissions to intensive care unit: A comparative study.

This descriptive observational study was carried out in Guru Teg Bahadur Hospital to identify predictors and outcome of obstetric admission to Intensive Care Unit (ICU). Ninety consecutive pregnant patients or those up to 42 days of termination of pregnancy admitted to ICU from October 2010 to December 2011 were enrolled as study subjects with selection of a suitable comparison group. Qualitative statistics of both groups were compared using Pearson's Chi-square test and Fisher's exact test.

A Randomised Controlled Trial Comparing the Efficacy and Side-Effects of Intravaginal Ring (Nuvaring(®)) With Combined Oral Hormonal Preparation in Dysfunctional Uterine Bleeding.

Introduction: Combined Oral Contraceptive (COC) pills are being used in patients of abnormal uterine bleeding, especially adolescents and reproductive age women considering their need for contraception. It decreases the blood loss due to haemostatic effect of estrogen and also regularizes the cycle. Intravaginal route has been found to be effective and acceptable; Gastrointestinal absorption and hepatic first-pass metabolism is avoided and steady, uniform blood concentration is achieved.

Use of the Sequential Organ Failure Assessment score for evaluating outcome among obstetric patients admitted to the intensive care unit.

Objective: To evaluate the prognostic value of the Sequential Organ Failure Assessment (SOFA) score among obstetric patients admitted to the intensive care unit (ICU).

Methods: A prospective study was conducted among 90 consecutive obstetric patients who were admitted to the ICU of Guru Teg Bahadur Hospital, Delhi, India, between October 6, 2010, and December 25, 2011. Maximum SOFA score was calculated for each of the six organ systems.

Adolescent ovarian masses: A retrospective analysis.

A retrospective study was conducted to review incidence, clinical practice, surgical management and histology of adolescent ovarian masses in order to audit and improve future practices. Complete hospital records of all adolescents between 10 and 20 years who had undergone surgery for ovarian masses were analysed between November 2006 to 2014. Parameters analysed were age, clinical features, diagnosis, operative procedure and histopathology.

Analysis of sexual assault survivours in a tertiary care hospital in delhi: a retrospective analysis.

Introduction: Rape and abuse of women are common occurrences, which, many a times go unspoken due to social stigma or fear of retribution. Rape is a crime not against a single human being but against the entire humanity. For granting justice to the rape survivor it becomes necessary that such matters are properly presented before the Courts of Law.

Hematometra formation- a rare complication of cesarean delivery.

Hematometra resulting from partial or complete obstruction of lower genital tract may be congenital or acquired. Commonest congenital causes are imperforate hymen and transverse vaginal septum. Acquired causes are senile atrophy of endocervical canal, scarring of the isthmus by synechiae, radiation and endocervical malignancy or due to surgical procedures.

Maintenance tocolysis with oral micronized progesterone for prevention of preterm birth after arrested preterm labor.

Objective: To evaluate the efficacy of maintenance therapy with oral micronized progesterone (OMP) for prolongation of pregnancy in cases of arrested preterm labor.

Methods: Ninety women at 24-34weeks of singleton pregnancy with intact membranes and arrested preterm labor were randomly allocated to receive OMP (n=45) or placebo (n=45) daily until 37weeks or delivery, whichever was earlier. Outcome parameters were compared using Student t test, χ(2) test, Fisher exact test, and log-rank χ(2) test.

Is nuchal cord justified as a cause of obstetrician anxiety?

Purpose: Birth asphyxia leading to acidosis comprises 20-60 % of perinatal mortality. Nuchal cord (NC) is one of the possible causes of birth asphyxia. Majority of fetuses who are antenatally detected to have nuchal cord are able to achieve successful vaginal birth.

Morbidly adherent placenta: a critical review.

Objective: To evaluate the demographic profile, high risk factors, fetomaternal outcome and management options in morbidly adherent placenta (MAP).

Study Design: Retrospective analysis.

Methodology: Review of 20 case records of women with MAP during year 2001-2006.

An unusual etiology of spontaneous pyometra perforation; a case report.

Introduction: By presenting this case we aimed to describe an uncommon complication of generalized peritonitis following spontaneous pyometra perforation in untreated cervical carcinoma.

Case Presentation: This report describes a 60-year-old postmenopausal woman presenting with clinical features mimicking intestinal perforation who was later diagnosed as cervical carcinoma with pyometra perforation at exploratory laparotomy. The patient had good post-operative recovery following drainage and peritoneal lavage.

Transabdominal amnioinfusion in preterm premature rupture of membranes.

Objective: To evaluate the effect of transabdominal amnioinfusion on prolongation of pregnancy, and maternal and neonatal outcomes in preterm premature rupture of membranes (pPROM).

Methods: We conducted a prospective randomized controlled study of women with pPROM during singleton live pregnancy-between 26 and 33+6weeks-whose amniotic fluid index (AFI) was less than the 5th percentile. The study group underwent transabdominal amnioinfusion at admission and then weekly if their AFI fell below the 5th percentile again.

Uterine avulsion: a rare cause of cryptomenorrhea.

Background: Cryptomenorrhea at menarche is commonly due to mullerian duct anomalies. Uterine avulsion due to blunt pelvic trauma is a very rare cause of cryptomenorrhea. But so far no case of uterine avulsion has been reported due to a childhood trauma without pelvic fracture.

Low-dose mifepristone in treatment of uterine leiomyoma: a randomised double-blind placebo-controlled clinical trial.

Aims: To evaluate the effect of low-dose mifepristone on leiomyoma-related symptoms, uterine and leiomyoma in women with symptomatic leiomyomata.

Methods: In a double-blind placebo-controlled trial, 40 patients with symptomatic leiomyoma and normal endometrial histology were randomised to receive 10 mg mifepristone (group 1) or placebo (group 2) daily for three months. Leiomyoma-related symptoms, uterine, leiomyoma and largest leiomyoma volumes were assessed at baseline and every month for three months.

Longitudinal vaginal septum 'obstructive variety'--a challenge for gynaecologist.

The cases which have been presented here have varied presentations but all the three patients in the series had acyclical abdominal pain. Since the uterus is functional there is collection of blood in the pouch formed due to the vaginal septum. This is a potential site for infection and could result in foul smelling discharge.

Pattern of severe maternal morbidity in a tertiary hospital of Delhi, India: a pilot study.

Severe maternal morbidity also known as 'near miss' may be a good indicator of the quality and effectiveness of obstetric care, as it may identify priorities in maternal care more rapidly than mortality alone. The objective of the study was to observe the pattern of severe maternal morbidity and its associated factors in a tertiary care hospital in Delhi. All patients admitted to the obstetrics and gynaecology department who fulfilled the definition of severe maternal morbidity conditions were included.

Myotonic dystrophy with pregnancy.

Myotonic dystrophy is a rare heredodegenerative muscular disorder in which pregnancy is unusual. Because of the autosomal dominant inheritance of the disease, 50% of children of an affected parent may have the disease; 20% of them are asymptomatic at birth. Foetal involvement may be manifested by polyhydramnios, arthrogryposis multiplex in utero, respiratory difficulties, and floppiness at birth.