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Background: In this study, we wanted to evaluate the incidence of adverse outcomes in pregnancy preceded by spontaneous abortion compared to those preceded by full term live births. Materials and methods: This was a hospital based prospective observational study conducted among 200 pregnant women with history of previous spontaneous abortions attending the antenatal OPD and labour room in the Department of Obstetrics and Gynaecology, J.L.N Hospital and Research Centre, Bhilai, Chhattisgarh, over a period of 11 months from 1st December 2019 to 30th October 2020 after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. Results: The incidence of oligohydramnios in case and control groups was 13 and 4% respectively. This has a p value of 0.022 which was statistically significant. The incidence of premature rupture of membrane (PROM) in case and control groups was 22 and 11 % respectively. This has a p value of 0.03 which was statistically significant. The incidence of PPROM in case and control groups was 7 and 1 % respectively. This has a p value of 0.03 which was statistically significant. 65.59 % patients underwent lower segment caesarean section (LSCS) among cases and 50 % patients underwent LSCS among controls. This has a p value of 0.037 which was statistically significant. 5.41 % of cases had emergency caesarean section while 57.14 % of controls had emergency caesarean section which was statistically significant (p value 0.042). 42.86 % of controls had elective caesarean section owing to large number of patients in control group with history of previous caesarean scar. Conclusion: Previous unfavourable pregnancy outcome increases the risk of adverse outcome in the future pregnancies. Majority of abortions in present pregnancy among both cases and controls are of first trimester abortions. There was significant association found between previous spontaneous abortion and oligohydramnios (13%), preterm delivery (16%), PROM (22%), PPROM (7 %), low birth weight (18.28 %), in the subsequent pregnancies. As the number of abortions increases, the incidence of term pregnancies decreases (A1-80.72%, A2-63.64 %, A3 - 60%, A4 - 0%). As the number of abortion increases, the incidence of oligohydramnios increases. The percentage of operative deliveries increases in the cases who had previous abortions. There was significant number of neonatal intensive care unit (NICU) admissions among cases. Previous abortions have a definite impact on the successful outcome of future pregnancies hence history of abortions in previous pregnancy should be investigated and treated. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of pregnancy on leiomyomas, effect of leiomyomas on pregnancy, the maternal morbidity and mortality and the perinatal outcome in pregnancies associated with leiomyoma. Materials and Methods: This prospective clinical study was conducted at Department of Obstetric and Gynecology, Medical College and Hospital, Kolkata from July 2012 to June 2013 on 40 pregnant women diagnosed with uterine leiomyoma. Results: Out of the total number of 40 cases, 87.5% were more than 25 years of age. Diagnosis was by antenatal ultrasound in 87.5%. Location of leiomyoma was subserous in 60%. They were 10-50cc in size in 50%of cases, single in 77.5%, 3 or more in number in only 15%. In pregnancy, size remained unaltered in 60%, 20% increased in size and 10% showed a decrease in size. At the end of puerperium they disappeared or decreased in size in 87.5% of cases. Complications developed in 35% of cases out of which 12.5% had complete abortions, 5.7% had placental abruption, 5.7% had premature rupture of membrane and 8.6% had preterm labour. Vaginal delivery occurred in 22.5%, 65% underwent LSCD. The major (26.9%) indication was malpresentation, 11.5% for myoma >30cc and 7.7% for leiomyoma in lower uterine segment. Caesarean myomectomy was possible in 50% patients. 5.7% of newborns had an APGAR score <7 at 1 min, all had an APGAR score >7 at 5 mins. Low birth weight babies were 22.9%. Conclusion: The course of leiomyoma in pregnancy is unpredictable, but complications may be avoided by repeated follow-up and a good pregnancy outcome can be achieved. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to evaluate the efficacy and safety of the medical method in the management of first trimester spontaneous onset incomplete abortion, by using misoprostol vaginal tablets, in comparison to surgical evacuation, with an intention of completing the procedure within 24 h. Methods: In this prospective, randomised study of 100 women admitted with features suggestive of incomplete abortion, 50 women received misoprostol vaginal tablets, while another 50 underwent suction curettage of products of conceptus. They were followed up after 24 h of last dosage of misoprostol or surgical intervention. Statistical analysis was done with respect to efficacy, safety and procedure-related side effects. Results: In this study, when analysed after 24 h of treatment allocation, the efficacy of misoprostol was 91.3 %, and the efficacy of the surgical method was 96 %, with the statistical difference being insignificant. Procedure-related blood loss and pain perception between the two groups were statistically insignificant. However, the incidence of fever in the misoprostol group statistically appeared higher. Conclusions: Misoprostol could be a safe and easily accessible alternative to surgical evacuation, in cases of first trimester spontaneous onset incomplete miscarriage, and could be administered by the patient herself at home. [ABSTRACT FROM AUTHOR]

Objective(s): The objective of this study was to evaluate the efficacy and safety of granisetron (5HT receptor antagonist) on the incidence of nausea and vomiting in cesarean deliveries under spinal anesthesia. Method(s): In the randomized, double-blind study, 80 parturients received granisetron 40 μg/kg or placebo ( n = 40 each) intravenously, immediately after clamping of the fetal umbilical cord. Nausea, vomiting, and adverse events were then observed for 24 h after administration of spinal anesthesia. Results: A complete response (defined as no postoperative nausea and vomiting) during 0-4 h after administration of spinal anesthesia was achieved in 80 % of patients with granisetron and in 45 % of patients with placebo. The corresponding incidences during (4-24 h) were 82.5 and 55 % ( P value <0.05). No difference in adverse events was observed in any of the groups. Conclusion(s): Prophylactic use of granisetron is effective for preventing emetic episodes during spinal anesthesia for cesarean delivery. [ABSTRACT FROM AUTHOR]

Objectives: To assess the efficacy of calciuria as a diagnostic test for the prediction of preeclampsia, and also to determine the changes in urinary excretion of calcium in preeclampsia and normotensive women. Methods: A prospective study was conducted on 60 primi mothers in the age group of 20-30 years, and all were enrolled at 16 weeks of gestation with clinical follow up by 4 weeks and 24 h urinary calcium and creatinine estimation. Ten mothers developed preeclampsia (study groups) and fifty remained normotensive (control groups). By means of Receiver-operator curve, a cut-off level of urinary calcium in 24 h was chosen for predicting preeclampsia. Results: Preeclamptic women excreted significantly less total urine calcium (87.0 ± 3.59 mg/24 h) than normotensive women (303.68 ± 17.699 mg/24 h) ( p < 0.0001) at 40 weeks of gestation. Urinary calcium and calcium/creatinine (Ca:Cr) ratio decreases progressively from 28 weeks to 40 weeks in the study group when compared to normotensive group. Conclusions: Preeclamptic women excrete less calcium than normotensive women. This parameter would predict preeclampsia earlier in pregnancy. [ABSTRACT FROM AUTHOR]