Pregnant women with symptomatic COVID‐19 should also be tested for TB in countries with a high burden of TB. The infrastructure of the TB Program can be utilized for the control of COVID‐19, and vice versa.
Introduction
Endometriosis is one of the common, gynaecological disorders
associated with chronic pelvic pain and subfertility affecting ~10% of
reproductive age women. The clinical presentation, etiopathogenesis of
endometriosis subtypes and associated risk factors are largely unknown.
Genome-Wide Association (GWA) Studies (GWAS) provide strong evidence for
the role of genetic risk factors contributing to endometriosis. However,
no studies have investigated the association of the GWAS-identified
single-nucleotide polymorphism (SNPs) with endometriosis risk in the
Indian population; therefore, one-sixth of the world’s population is not
represented in the global genome consortiums on endometriosis. The
Endometriosis Clinical and Genetic Research in India (ECGRI) study aims
to broaden our understanding of the clinical phenotypes and genetic
risks associated with endometriosis.
Methods and analysis
ECGRI is a large-scale, multisite, case–control study of 2000
endometriosis cases and 2000 hospital controls to be recruited over 4
years at 15 collaborating study sites across India covering
representative Indian population from east,north-east, north, central,
west and southern geographical zones of India. We will use the World
Endometriosis Research Foundation Endometriosis Phenome and Biobanking
Harmonisation Project (WERF-EPHect) data collection instruments for
capturing information on clinical, epidemiological, lifestyle,
environmental and surgical factors. WERF-EPHect standard operating
procedures will be followed for the collection, processing and storage
of biological samples. The principal analyses will be for main outcome
measures of the incidence of endometriosis, disease subtypes and disease
severity determined from the clinical data. This will be followed by
GWAS within and across ethnic groups.
Ethics and dissemination
The study is approved by the Institutional Ethics Committee of
Indian Council of Medical Research-National Institute for Research in
Reproductive Health and all participating study sites. The study is also
approved by the Health Ministry Screening Committee of the Government of
India. The results from this study will be actively disseminated through
discussions with endometriosis patient groups, conference presentations
and published manuscripts.
The incidence of multiple pregnancies varies in different populations and countries. Twinning rates in India are reported to be below 9 per 1000 births. 1 As of October 20, 2020 SARS-CoV-2 (COVID-19) had affected approximately 40 million individuals globally and caused more than 1 million deaths, 2 including many pregnant women with twin gestation. Multiple gestational pregnancies (MGP) are associated with a high risk of both fetal and maternal complications and require
Objective: To study clinical, surgical characteristics and the relationship between endometriosis lesion types and conception rate after surgery in infertile women with endometriosis.Methods: A prospective, multicenter cohort of 204 women (age 20-35 years) with endometriosis was followed up post-surgery between November 2017 and February 2020 at three tertiary-care hospitals.Results: Based on the severity of endometriosis lesion type, deep infiltrating endometriosis (DIE) (81/204, 39.7%) was the most common lesion; followed by ovarian endometriosis (OMA) (64/204, 31.4%), and superficial peritoneal endometriosis (SUP) (59/204, 28.9%). Endometriosis patients had a single lesion type (94/204, 46.1%), two lesion types (77/204, 37.7%), or three lesion types (33/204, 16.2%) with significant differences between regions (P < 0.001). Around 40% (37/95) of obese women had SUP (P = 0.003) whereas 78% (14/18) of underweight women had DIE (P < 0.001).Significant differences in mean Endometriosis Fertility Index scores between endometriosis lesion types and patients with one, two, and three types of lesions were observed (P < 0.001). The majority (22/32, 68.8%) of the women conceived naturally after the surgery. Half (16/32; 50%) of the women with a single lesion type conceived after the surgery; of which most (13/16, 81.2%) had SUP, followed by OMA (2/16, 12.5%), and DIE (1/16, 6.3%).
Conclusion:Women with SUP and only one type of endometriotic lesion were more likely to conceive post-surgery.
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