Search

Recurrent pregnancy loss (RPL) mainly occurs due to the disorders that cause intrauterine fetal demise or damage, such as fetal, maternal, and paternal chromosomal structural and numerical abnormalities. Approximately, 15-20% of all clinically recognized pregnancies result in the first trimester (before 20 weeks of gestational age) in spontaneous recurrent abortion. Besides all internal factors like Anatomical, immunological, and coagulation factors, genetic factors appear to be most associated with reproductive organ damage and multiple pregnancy loss. Some factors are unexplored as mentioned in the previous research articles, and there is an enormous need to research for establishing the proper etiology and prognosis. This review is all about the various factors responsible for RPL and is mainly focused on the genetic factors involving many unexplored genes associated with recurrent miscarriages. In this review, searched the articles with keywords that were published recently from various journal searches such as Google Scholar, Science Direct, and the National Center for Biotechnology Information (NCBI) platform. [ABSTRACT FROM AUTHOR]

Background: Intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis, is characterized by pruritus, elevated serum bile acids, and elevated transaminases in late second and third trimester of pregnancy. A low amount of vitamin D in serum is associated with intrahepatic cholestasis during pregnancy. Objective: To study the correlation of 25(OH) vitamin D3 in ICP with normal pregnancy, and neonatal outcomes in patients with ICP. Materials and methods: The study is a case-control study, conducted with pregnant women coming to OPD or labour room of Sir Sunderlal Hospital, BHU. Serum levels of 25(OH) Vitamin D3 were measured using a CLIA method; (Roche Diagnostics International Ltd., USA). Neonatal outcomes were also studied. Result: The mean SGPT, SGOT, total bilirubin, and alkaline phosphatase levels were significantly raised in ICP group as compared to control group. The mean serum bile acid was significantly high in ICP group as compared to control group (p<0.001). Conclusion: Serum 25(OH) vitamin D3 levels are significantly low in cases of ICP as compared to normal pregnancy. Serum 25(OH) vitamin D3 levels in ICP are inversely correlated by meconium staining, a major indicator of foetal distress. [ABSTRACT FROM AUTHOR]

Introduction: Endometriosis is an oestrogen dependent gynaecological disease, having endometrial glands and stromal tissues outside the intrauterine locations. The etiology and pathogenesis of endometriosis is still unclear and it affects a large proportion of reproductive age women. It's a heterogeneous disease and is found to be associated with hormonal and histological alterations. Studies indicate that mutation in aromatase (CYP19) gene is involved in a number of inflammatory diseases and CYP19 rs 2470152 site polymorphism may help to find its relation to susceptibility to endometriosis. Aim: To ascertain the relationship between changes in histological architecture in endometrial cells during endometriosis with circulating hormone levels, stress parameters and aromatase (CYP19A1) gene polymorphism {Single Nucleotide Polymorphism (SNP) rs 2470152}. Materials and Methods: This was a hospital-based casecontrol study where all patients and controls were recruited from the Outpatient Department (OPD) of the Sir Sunderlal Hospital, Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University (BHU), Varanasi, India from March 2016-March 2019, and a total 300 subjects, 120 endometriosis patients and 180 healthy controls were studied. Histological studies were done by Haematoxyline-Eosin (H&E) staining in the endometrial tissues of patients and controls. Genotyping of SNP rs 2470152 was conducted by Polymerise Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method on genomic Deoxyribonucleic Acid (DNA) isolated from patients and control blood. Student's t-test was used to compare the mean for the two independent groups. Allele and genotype distribution among groups were evaluated using the Chi-squared test and Fisher's exact test. Results: In the present study, all the subjects were in the age group of 20-50+ years where 20-40 years age group were premenopausal and 40-50+ year were perimenopausal. Significant histological changes were observed in the endometrial glands and stroma of the endometrium tissues of the diseased women compared to the healthy controls. Various pathological entities were altered in circulating blood plasma of patients than to control. For polymorphism studies allele (T,C) (p=0.002*) and genotypic (TT, TC and TT) (p<0.001*) frequencies were found significantly variable in endometriosis patients in comparison of controls. Conclusion: This study showed that endometrial tissue undergoes a lot of pathological changes during a disease and this may be due to significantly altered expression of aromatase gene leading to higher oestrogen level, causing this disease and its proliferation. Aromatase (CYP19A1) gene polymorphism was found significantly associated, and other factors may be affecting aromatase directly or indirectly in steroidogenic pathway. [ABSTRACT FROM AUTHOR]

Background and Aims: Female infertility is a complex multifactorial, and polygenic disease associated with genetic factors plays an essential role in its formation and follicle development, oocyte maturation, and steroidogenesis regulation in the ovary. The aim here is too study the genetic association between follicle-stimulating hormone receptor (FSHR) Asn680Ser; (rs6166) gene polymorphism with female Infertility in our population. Methods: In this prospective case-control study, we enrolled 106 infertile and 164 unrelated healthy control individuals. Genomic DNA was extracted from the 5 ml of venous blood using the modified salting-out method. A polymerase chain reaction-amplified exon 10 of FSHR and purified PCR products were sequenced on an ABI 3730XL DNA sequencer. The data were analyzed statistically. Results: We found that the presence of rare allele "G" and heterozygous and common homozygous genotypes significantly increased the risk of female infertility. No significant change in the FSHR 191756 G >A genotype frequency was observed, regardless of chromosomal integrity. The genotype frequency distribution of locus 680 was consistent with the Hardy–Weinberg Equilibrium (HWE) in both groups (P > 0.05). Conclusion: No significant differences were found in allelic variants frequency and genotype distribution between each category of subjects when analyzing the FSHR SNPs in the exonic region (P value >0.05). FSHR Asn680Ser polymorphisms and female infertility (P > 0.05). Variations in FSHR gene have an essential influence on ovarian function and can account for several defects of female fertility. FSHR Asn680Ser (rs6166) gene polymorphism is associated with female infertility and can be used as a relevant molecular biomarker to identify the risk of infertility in our population. This finding can be important for disease pathogenesis. [ABSTRACT FROM AUTHOR]

Background: Obstructed labour contributes to eight percent of maternal deaths in India. It is also one of the leading cause of perinatal morbidity and mortality in developing countries. OJb/ective:Tostudythe risk factors and fetomaternal outcome in obstructed labour at SirSunderlal hospital, BHU, Varanasi. This will help us to assess obstetric near miss and to develop strategies to decrease the complications resulting from obstructed labour. Materials & Methods: This was a one year retrospective study by reviewing the records of obstructed labour conducted from April 2015 to March 2016. Results: There were 52 cases of obstructed labour among 2381 total deliveries. Most common cause for obstructed labour was cephalopelvic disproportion (73%) followed by malposition/malpresentation (17.3%). Majority of the patients (69.2%) belonged to poor socioeconomic group. Sepsis (9.6%) and pyrexia (9.6%) were the common complications. Neonatal mortality was 30.8% and maternal mortality was 5.8%. Conclusion: Lack of health education, antenatal care, low socioeconomic condition, poor referral system and demographic factors are important contributory factors leading to adverse outcome of obstructed labour. This can be sorted out by proper antenatal care, improving health care delivery system especially in rural areas and timely referral of cases. [ABSTRACT FROM AUTHOR]

Rudimentary horn pregnancy is rare but, if occurs it gives a grave risk to the health of the pregnant woman. In most cases it presents in the form of ectopic pregnancy. Despite availability of good USG facility, it is very difficult to timely diagnose rudimentary horn pregnancy. Confirmatory diagnosis made only by laparoscopy or during laparotomy. In the rudimentary horn the constitution of the muscle wall thickness is variable so the pregnancy can be accommodated until late pregnancy. Here we present a case of 24 years female Gravida3 Para2 Live2 with 14 weeks pregnancy presented to us in shock with clinical features of ruptured ectopic pregnancy. On laparotomy we found non-communicating rudimentary horn rupture with dead fetus in peritoneal cavity. [ABSTRACT FROM AUTHOR]

Malignant ovarian germ cell tumours (OGCT) comprise only 2-5% of all ovarian malignant cancers. Endodermal sinus tumour (Yolk sac tumour-YST) is the second most common malignant germ cell tumour of the ovary atier dysgerminoma and comprises approximately 20-25% of malignant germ cell tumours and 2 - 5% of all the ovarian malignancies. YST is almost always unilateral and large. YST are highly aggressive and because of the early metastatic or invasive behaviour, their prognosis has been poor. Here, we report a case of endodermal sinus tumour in a 19-year-old girl with lower abdominal pain for one month. A pelvic mass was found and being investigated but emergency laparotomy was performed for severe acute abdominal pain. An intraoperative diagnosis of Stage IIIC ovarian tumour with bilaterality and intraperitoneal rupture was made. She required extensive debulking surgery, later confirmed as yolk sac tumour. [ABSTRACT FROM AUTHOR]

Problem: Vitamin D is well‐known for having anti‐inflammatory and immunomodulatory properties. Impaired maternal vitamin D status has been known to increase the risk of adverse pregnancy outcomes like pre‐term birth. The present study aims to evaluate the impact of fetal cord serum 25‐hydroxyvitamin D‐mediated signaling in mediating inflammatory responses in placenta during pre‐term birth. Method of study: For the above purpose, cord serum 25 hydroxyvitamin D 25(OH)D were measured in term (n = 20) and pre‐term (n = 20) born babies using ELISA. Vitamin D downstream signaling has also been checked in placenta (VDR, CYP27B1, cathelicidin LL37) along with expression of inflammatory markers (S100A8, HMGB1, TLR2, p‐NF‐kappaB) using Western blotting and immunohistochemistry. Pearson correlation model was used to do correlation study. Results: Compared with term born babies (59.31 ± 3.476), decline in cord serum 25(OH)D levels is observed in pre‐term born babies (22.26 ± 1.083, P = <0.0001) that showed strong positive correlation with gestational age (r =.9368***) and birthweight (r =.9559***). On the other hand, vitamin D signaling markers were found to be downregulated and inflammatory markers were upregulated in placental tissue of pre‐term born babies. Conclusion: Thus, our study demonstrated that insufficient cord 25(OH)D levels may disturb the homeostasis of inflammation in placenta. Altered cord serum 25(OH)D mediated anti‐inflammatory signaling may be acting as trigger signals in modulating inflammatory responses in placenta and eliciting premature activation of spontaneous labor in pre‐term birth. [ABSTRACT FROM AUTHOR]