No abstract

Background: Perimenopausal period in a woman’s lifetime marks a transition from reproductive phase to that of menopause. Abnormal uterine bleeding (AUB) is a common problem among women in the reproductive age.Methods: It was a prospective study on 100 perimenopausal women in age group 39-51 years with abnormal uterine bleeding who underwent Hysterectomy at SMS Hospital, Jaipur. At the end clinical diagnosis, ultrasonographic findings and histopathological reports were correlated.Results: 42.0% cases had HMB menstrual pattern followed by 24.0% cases had HPMB and 18.0% of the cases had PB. Intermenstrual bleeding was seen in 2% cases.  In clinical finding, 71.0% cases had fibroid followed by 15.0% cases had adenomyosis and 6.0% of the cases had fibroid+adenomyosis. The clinical diagnosis was confirmed by ultrasonography. Ultrasound detected fibroid in 95.8% of the cases who were suspected to have fibroid on clinical examination. Out of the 15 patients who were clinically suspected to have adenomyosis, 53.3% confirmed on ultrasound, ultimate diagnosis was made on the basis of histology, so every hysterectomy specimen was sent for histopathological examination. Out of the 68 patients who were diagnosed to have fibroid uterus on ultrsonography, 66 patients were confirmed to have fibroid. Out of the 8 patients who were labelled as adenomyosis after ultrasound, 4 patients were diagnosed to have adenomyosis on histopathology and in rest 4 patients, no gross pathology was detected.Conclusions: A transvaginal ultrasound should be offered as the first line of imaging. Clinical, radiological and pathological evaluation correlated well to diagnose fibroids, however clinically as well as USG proved to be of little help in diagnosing adenomyosis.

Background: Childbirth is the period from the onset of regular uterine contraction until expulsion of placenta. The process by which this normally occurs is called labour. Induction of labour is the artificial initiation of uterine contraction prior to their spontaneous onset, leading to progressive dilatation and effacement of the cervix and delivery of the baby. Labour induction is indicated where the benefits to either the mother or the fetus outweighs the benefit of continuing pregnancy. The aim and objectives of the study was to study the progress of labour in nulliparous women who are having spontaneous labour and in those with induced labour in terms of augmentation of labour, mode of delivery, neonatal outcome and maternal complication. Methods: Women recruited into the study in labour room of Cosmopolitan hospital. Case recruited when they came for elective induction and controls when they came in spontaneous labour after considering inclusion and exclusion criteria. The study included information after signature of a consent form from the women who came in the labour room for induction of labour during my study period (June 2013-December 2014). Low risk primigravida of age <35 years at 37 weeks to 42 weeks of gestation with elective labour inductions included. Mother and baby followed up after delivery in the wards or in NICU for outcome upto the time of discharge. We studied for the following maternal outcomes: method of induction, mode of delivery, duration and complications of stages of labour, postpartum hysterectomy; admission to the ICU; duration of postpartum stay in hospital; and maternal status at discharge. We assessed the following perinatal outcomes: at 5th minute Apgar score; birth weight; birth injuries; respiratory distress syndrome; admission to the NICU; number of days in NICU; neonatal deaths taking place in hospital within the first week of life; stillbirth or intrauterine death; neonatal jaundice and need for phototherapy. Results: Mean duration of 1 st stage in induced group was 15.33 hours (SD=7.41) and in spontaneous group was 10.73 hours (SD=3.79). Median time was 13 hour for induced group and 10 hour for spontaneous group. This difference was statistically significant (p <0.0001).Mean duration of 2 nd stage in induced group was 1.53 hours (SD=0.94) and in spontaneous group was 1.22 hours (SD=0.51). Median time was 1.5 hours for induced group and 1 hour for spontaneous group. This difference was statistically significant (0.007). Mean duration of 3 rd stage in induced group is 6.21 minutes (SD 5.147) and in spontaneous group is 5.38 minutes (SD 2.675). Median time was 5 minutes for induced group and spontaneous group. This difference was not statistically significant (p = 0.51). 14.8% of induced group had Protracted latent phase compared to 4.9% in spontaneous group. This difference was statistically significant (p=0.017). 9.9% of induced group had meconium stained liquor compared 9.9% of induced group had fetal distress compared 3.7% in spontaneous group. This difference was not...