Search

Background: Caesarean delivery is one of the most commonly performed operations today. Caesarean births have become safer. Primary caesarean section in a multipara means first caesarean section done in the patients who had delivered vaginally once or more. Mainly the baby and the placenta are responsible for caesarean section in multipara. Methods: It was a prospective randomized hospital based study of primary caesarean sections performed in multiparous patients at Dhiraj General Hospital at the Department of Obstetrics and Gynecology. In this study analysis of the cases in relation to different factors have been done. Results: Amongst the various indications for caesarean section in multipara, fetal distress (25.58%) and antepartum hemorrhage (22.09%) were with the highest incidence. Conclusion: Previous vaginal delivery gives the patient as well as her relatives a false sense of security. There are many cases where a caesarean becomes mandatory for her. The fact that a multipara has had one or more vaginal deliveries should be regarded as an optimistic historical fact, not as diagnostic-criteria for spontaneous delivery of the pregnancy at hand.

Background: Since beginning it’s a dilemma whether to remove or preserve the ovaries. In the present study an attempt is made to understand this phenomenon and to have some direction for removal of ovaries. Preservation of the ovaries at the time of hysterectomy does not seem to compromise patient care. Impaired function or failure of the retained ovaries, however, is not uncommon; close post-treatment surveillance is therefore important in terms not only of recurrent disease but of function of the ovaries as well. Methods: This study was done on 37 patients in duration of 3 years from June 2009 to May 2012. It is a retrospective statistical hospital based study of re-laparotomy done in post hysterectomised patients. Results: The most common pathology in these patients was a simple ovarian cyst (45.95%), followed by endometriotic cyst (21.62%), mucinous adenoma (8.10%), serous cyst adenoma (5.40%), serous cyst adenocarcinoma (2.70%) and poorly differentiated adenocarcinoma (2.70%). Conclusions: Emergence of pelvic mass after hysterectomy poses diagnostic and therapeutic challenge to gynecologists. In future, as the patients become more aware and the clinicians more enlightened on the long term benefits and risks of hormone replacement therapy, decisions might be easier for the patients and the clinicians alike.

Background: Gestational diabetes (GDM) represents carbohydrate intolerance first discovered in pregnancy, occurs in 3.8-21% of pregnancies. Postpartum glucose intolerance returns to normal in majority. However, there is high risk of developing impaired glucose tolerance or overt diabetes mellitus later in life. Balanced diet at proper time can help achieving glycemic control. It also helps women with GDM to avoid need for insulin reducing costs of treatment.Methods: Study was done in Dhiraj Hospital in Obstetrics and Gynecology department. Study duration was 1.5 years. It was a prospective study comprising of patients who came with raised blood glucose levels on their 1st visit.Results: Prevalence of GDM (2.87%) is observed to be comparable to various other centres. Highest number of GDM cases was observed in age group of 26-30 years (62.96%). Control of glycemia with diet could be achieved in majority of women (53.85%) at 3 months post-partum as reflected by FBS levels. Incidence of Macrosomia (29.63%) and LSCS (77.78%) could not be lessened by glycemic control with diet in women with GDM.Conclusions: Prevalence of GDM was comparable to that of other studies. Rate of caesarean section was very high and main indications being foetal distress and cephalopelvic disproportion. Maternal and perinatal morbidity increases as duration of GDM increases. Control of glycemia with dietary treatment can help reduce occurrence of complications in mother and baby. It requires proper compliance, absence of which calls for need of insulin in most of patients with uncontrolled glycemia since first.