Background: This is a prospective study was conducted at Obstetrics and Gynecology department, tertiary care Hospital, to compare the accuracy of clinical and ultrasonographic estimation of fetal weight at term with actual birth weight.Methods: The present study is a prospective comparative study of fetal weight estimation in Antenatal women with term gestation (37week to 42week of gestation) singleton pregnancy with vertex presentation, who had gestational age confirmed by dates and ultrasound scanning of< 22weeks admitted in tertiary care center from March 2016 to November 2016. Patients with Polyhydramnios, oligohydramnios, Antepartum hemorrhage, Congenital anomalies of fetus, Obese (Body mass index >30 kilogram/meter2) are excluded from the study. Estimation of fetal weight is done by clinical method and ultrasonography. Birth weight after delivery was recorded in grams by electronic weighing machine and tabulated.Results: Clinical as well as ultrasonography estimates observed to be strongly correlate with actual birth weight. Both the methods had more sensitivity in birth weight range 2500-4000gm than <2500g and >4000g. The overall mean absolute percentage error of the clinical method (7.2±7.7) was smaller than that of the sonographic method (16.2±11.1). In low birth-weight (<2,500g) group, mean absolute percentage error was 9.0±11.3 with USG and same with clinical was 11.7±9.0. No statistically significant difference was observed.Conclusions: The present study concludes that clinical estimation of birth-weight is as accurate as routine ultrasonographic estimation.Clinical palpation should be considered as diagnostic tool for FWE and is equally reliable even when done by trained medical person. It is cheap and easy to teach. The need is to practically apply this method in obstetrics and guide the management decisions.
Background: Carcinoma cervix is the most common cancer among women in developing countries. The objectives of the study were to study the sensitivity and specificity of visual inspection of the cervix with acetic acid (VIA) and Lugol's iodine (VILI) for cervical cancer screening. To study the correlation of demographic data like age, socioeconomic status, education residential area, parity, age at marriage in premalignant lesion of the cervix.Methods: The present study was conducted in the department of Obstetrics and Gynecology at a Tertiary Medical Care Center over a period of two years. Five hundred fifty women between 20-65 years of age who fulfilled the selection criteria were enrolled in our study. Positive tests for VIA was opaque aceto white lesion on applying 5% acetic acid or detection of definite yellow iodine non uptake areas with Lugol's iodine in the transformation zone or close to touching the squamocolumnar junction. Positive cases were scheduled for cervical biopsy. Ethical approval of the study protocol was obtained from the ethics committee of the institute.Results: On down staging 7.2% (40/550) of cases had an unhealthy cervix and 0.36% (2/550) with a suspicious cervix. VIA positive in 4.55% (25/550), VILI positive in 2.73% (15/550). Biopsy was taken from positive with VIA and VILI. On histology 2.9% (16) were chronic cervicitis, CIN I had (1), 0.2%, CIN II (2) 0.4%, CIN III (4) 0.7% and squamous cell carcinoma (2) 0.4% VIA sensitivity 72.22%, specificity 97.74%. VILI sensitivity 100%, specificity 98.89%.Conclusions: VIA and VILI are simple, inexpensive, low resources technique. Both have high sensitivity and specificity.
Background: Epidural analgesia is regional anaesthesia that blocks pain in a particular region of the body. The use of Epidural Analgesia (EA) in labor is widespread in modern labor ward practice, and its benefits in terms of pain relief are well-recognized. Objective of this study was to study the effect of epidural analgesia on the duration of labour and pains.Methods: The present study was conducted on 60 women in the department of obstetrics and gynecology at Topiwala National Medical College, Mumbai during a period from October 2014 to January 2017. The women requesting EA were assigned as the study group (Group A - 30 cases) and women not receiving EA were included in the control group (Group B - 30 cases).Results: The duration of active phase of first and second stage of labour was found to be prolonged in patients who received EA as compared to control group. An increase in number of caesarean sections and requirement of oxytocin augmentation was found to be more in Group A as compared to Group B. There was no statistically significant difference in Apgar score of newborns at 1 min and 5 min in both the groups. The patients demanding epidural drug had better pain relief during labour. In Group A, 17% of patients and in Group B, 7% of patients had nausea and vomiting. Other side effects were minimal.Conclusions: Epidural analgesia is not a totally free of disadvantages, it is the most effective mode of pain relief available compared with other techniques. The addition of patient-controlled epidural analgesia and innovations using new technologies enhance patient satisfaction.
In adolescent Ovarian cysts are an extremely common gynaecological problem. Majority of ovarian cysts are benign with few cases being malignant. Ovarian serous cystadenomas are rare in children. A 14-year-old presented with severe abdominal pain and abdominal distention. She underwent emergency laparotomy and surgical removal, the mass was found to be torsion of ovarian serous cystadenoma-fibroma on histology. In conclusions, germ cell tumours the most important causes for the giant ovarian masses in children. Epithelial tumours should not be forgotten in the differential diagnosis.
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