Journal of Evolution of medical and Dental Sciences, 2013
BACKGROUND: Due to active involvement of fetal system in regulation of amniotic fluid volume, AFI... more BACKGROUND: Due to active involvement of fetal system in regulation of amniotic fluid volume, AFI has been identified as indicator of intrauterine fetal status. USG has revolutionized the process of assessment of amniotic fluid thus becoming an integral part of fetal surveillance. Polyhydramnios is an obstetrical condition associated with significant perinatal and maternal morbidity and mortality. In a low resource health facility as India with poor coverage of antenatal care and malnutrition it still becomes more important to screen pregnancies for such high risk factors. AIMS: 1. To study incidence of polyhydramnios. 2. To identify major etiological factors of polyhydramnios. 3. To study perinatal outcome. SETTINGS AND DESIGN: A hospital based cross section study for duration from 1 st May 2009 to 31 st October 2010. MATERIAL & METHOD: All the cases identified as polyhydramnios according to AFI in four pocket were included in the study. The cases identified as having polyhydramnio...
Background : The study was conducted to compare post-placental intrauterine contraceptive device ... more Background : The study was conducted to compare post-placental intrauterine contraceptive device insertion with immediate post partum IUCD in terms of acceptance, safety and expulsion in vaginal deliveries. Methods : This was a prospective longitudinal study. 397 willing women were inserted PPIUCD out of which 305 were in post placental period while 92 in immediate post partum period. Outcomes were studied at 6 weeks. Results : 76.8% of PPIUCD insertions were post placental whereas only 23.17% were in the immediate postpartum period. 83.38% of clients returned for follow-up whereas 16.12% of clients were lost during the study. In the post placental group,89.5% of women retained their IUCD after 6 weeks of insertions, while in the immediate postpartum IUCD insertion group only 34.14% retained the IUCD at follow-up visit.(p<<<0.0001) Conclusion : Expulsion rates are more in immediate post partum IUCD than post placental IUCD therefore it is better to insert CuT immediately a...
Journal of Evolution of medical and Dental Sciences, 2013
Heterotopic pregnancy is rare and its continuation as secondary abdominal pregnancy is even rarer... more Heterotopic pregnancy is rare and its continuation as secondary abdominal pregnancy is even rarer. A patient who had received ovulation induction presented with history of expulsion of four foetuses followed by abdominal distension and pain in abdomen. Ultrasound was suggestive of rudimentary horn pregnancy. She was kept on conservative management and at 33 weeks, emergency laparotomy was done. She had secondary abdominal pregnancy without hemoperitoneum, receiving vascular supply from ruptured rudimentary horn. Rudimentary horn was removed and patient was discharged successfully with live and healthy baby.
Journal of Evolution of medical and Dental Sciences, 2013
This work is a cross sectional study at a tertiary care centre done over a duration of one year w... more This work is a cross sectional study at a tertiary care centre done over a duration of one year with the aim to determine major indications and incidence of obstetric ICU admissions, to find out duration of ICU stay and determine maternal outcome. The three most common indications of Obstetric ICU admission were haemmorrhage followed by hypertensive disorders and iron deficiency anemia.The mean duration of ICU stay was 6.1 days. Maternal mortality was 6.54 % of the total obstetric patients admitted to our ICU. To conclude , establishment of dedicated obstetric ICU at tertiary care centre with knowledge , familarity, experience and expertise of an obstetrician and special team would be the best place to monitor and treat a critically ill obstetric patient which will reduce the maternal morbidity and mortality.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variabl... more Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during the present pregnancy. It affects 7% of all pregnancies worldwide and in India it ranges from 6 to 9% in rural and 12 to 21% in urban area. The aim of this study was to compare the DIPSI criteria with the two-step method (Carpenter and Couston criteria.) and to study merits and demerits of one step and two step tests for GDM.Methods: A total 400 pregnant women of gestational age between 24-28 weeks attending antenatal clinic at this study tertiary care center were enrolled in this study. 200 pregnant women were enrolled in each of the study group (Group I OGTT and Group II DIPSI).Results: In Group I (OGTT) screening 47 (23.5%) were tested positive. In Group II cases, screening test results were found positive among 44 (22%). Out of 95 high-risk pregnant women 38 (40%) were positive for GDM by OGTT and 34 (35.78%) were positive by DIPSI. O...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy.... more Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. Aim of this study was to identify thyroid dysfunction as a maternal health problem. Objective of this study was to study the maternal outcomes in these patients.Methods: The main source of data are the patients admitted in Sultania Zanana Hospital, GMC Bhopal. The study was an observational prospective study conducted from March 2018 to February 2019.Results: The present study was conducted in department of obstetrics and gynecology, Gandhi Medical College and associated Sultania Zanana Hospital Bhopal for the period of 1 year. The study could enroll 400 females fulfilling the inclusion criteria during the study period.Conclusions: In developing countries like India where there is prominent micronutrient deficiency, iodine deficiency further aggravates the condition and carries a great potential to show deleterious impacts on maternal and fetal outcomes, thus serving a major health prob...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: Anemia during pregnancy is a global public health challenge facing the world today. A... more Background: Anemia during pregnancy is a global public health challenge facing the world today. Among the South Asian countries, WHO estimate that India has the highest prevalence of anemia in pregnancy. Prevalence of anemia in pregnant Indian women is 49.7%, against the global prevalence of 41.8% (WHO 2008). In India, the prevalence of anemia is high because of ignorance, poverty, fewer intakes of iron, folic acid and food sources and gender bias significantly contribute to this high prevalence. Hence, this study aims to identify the risk factors and red cell morphological pattern that contribute to the presence and severity of anemia among pregnant women at the Sultania Zanana hospital, Gandhi Medical College Bhopal.Methods: The present study was conducted in Department of Obstetrics and Gynaecology, Sultania Zanana Hospital, Gandhi Medical College, Bhopal, Madhya Pradesh, India. The study included all pregnant women at third trimester who was admitted at Sultania Zanana hospital,...
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 2020
BACKGROUND:Anemia during pregnancy is a global public health challenge facing the world today. It... more BACKGROUND:Anemia during pregnancy is a global public health challenge facing the world today. It is estimated that around 2 billion people, 30% of the world population are affected with the majority coming from the developing world. AIM:This study was conducted to assess the prevalence of anaemia and its associated morbidity amongst pregnant females. MATERIALAND METHOD: The present study was a hospital- based observational study that was conducted in Department of Obstetrics and Gynaecology, Sultania Zanana Hospital ,Gandhi Medical College, Bhopal ,Madhya Pradesh, India and included all the pregnant women in third trimester of pregnancy with haemoglobin levels less than 7 who were admitted between January 2016 to December 2016. Data were analysed using SPSS v20. RESULT: A total of ve hundred cases were enrolled for the study.Most were 21-35 year old (74.2%) followed by less than 20 year old subjects (18.8%). Anaemia was more prevalent among rural population as compared to urban po...
Journal of Evolution of medical and Dental Sciences, Oct 10, 2013
IUGR is one of the most serious challenges in both developed and developing contraries. It is the... more IUGR is one of the most serious challenges in both developed and developing contraries. It is the single most important factor that determines in chances of child survival. In our country PGRF remain one of the commonest cause of neonates morbidity and mortality 30% of neonatal death are done to IUGR. Despite of all efforts by government 100% antenatal care is poor but women are seeking health facility for delivery at time ever more important to identify such high risk pregnancy and manage for better met and fetal examination (one step) in 3 rd trimester can be used as a screening procedure for detection of IUGR babies. MATERIAL AND METHODS: all pregnant women coming to the facility diagnosed to have IUGR by clinical method (SFH, AG, clinical assessment of liquor) were included in the study for duration of one year. Maternal and fetal outcome was noted in terms of mode of delivery and neonatal death, still birth, SGA, AGA. Apgar score of all the babies was noted to assess morbidity. OBSERVATION: Of the total antenatal women 200 were identify as IUGR by clinical method out of which most of were from age group 21-25 years comprising 72.4% of total cases. Maternal weight and height influence weight of the babies 75% IUGR babies were noted in height less than 145 cm. 78.5% were unbooked and 64 belong to rural population. various risk maternal factors like hypertensive disorder 26%, anemia 16.5%, previous history of IUGR 9%, antepartum haemorrhage 6%, diabetes 1%, rh negative 4.5%, heart disease 1%, recurrent abortion 5% in 17% no identified risk factors were found, 80% were delivered vaginal, 67.5% babies were SGA after birth as assessed by clinical method, 68%, had Apgar score less than 7. Perinatal mortality constituted 27.3% of the babies. DISCUSSION: Intrauterine growth restriction is one of the common abnormality encountered by the obstetrician, when present it increases perinatal morbidity and mortality. it is a multifactorial disease with varying degree of severity as in our study the noted 68% of babies with Apgar less than 7 and only 32 had Apgar more than 7 with perinatal mortality of 27.3%. IUGR per se is a major problem in India, nearly million low birth weight babies are born annually in India and it account for more than half of neonatal death. This is evidenced in our study that we were able to screen and detect 67.5% of babies who were SGA out of total screen as IUGR. This study also emphasizes the fact that IUGR as cause of neonatal morbidity and mortality can be reduced if proper antenatal care prompting early detection of high risk factor and IUGR is done. One step method of clinical assessment of IUGR can be included in maternal health programs focusing on early detection of IUGR and associated maternal risk during antenatal period and early referral to more complete health care centres where they can be benefited by more sophisticated diagnostic and therapeutic methodology such as colour doppler and ultrasound. INTRODUCTION: IUGR is one of the most serious challenges in both developed and developing countries. It is the single most important factor that determines the chances of child survival.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: The objective is to determine the knowledge, attitude and preventive practice of wome... more Background: The objective is to determine the knowledge, attitude and preventive practice of women above 45 years old.Methods: It is a cross-sectional analytical study of 100 women above 45 years of upper class women. The interview schedule consisted of 4 parts including questions about knowledge, attitude and practice (KAP) and also demographic questions.Results: A significant relationship between the score of preventive practice and all the following parameters was found: level of education, hearing about osteoporosis, knowledge score, perceived barrier to preventive actions and perceived seriousness of osteoporosis.Conclusions: Inaccurate or insufficient knowledge and their negative attitude to the preventive actions and their weak practice in case of prevention, it is the responsibility of health policymakers and medical associations to plan for osteoporosis education and prevention initiatives.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2013
India is the second most populous country in the world, sustaining 17.01% of world population on ... more India is the second most populous country in the world, sustaining 17.01% of world population on 2.4% of world's surface area. According to Census 2011 the population of India on 1 March 2011 was 1,210,193,422. In spite of availability of wide range of contraceptives, the unmet need for family planning is estimated to be 12.8%. The common reasons for unmet need are unsatisfactory services, lack of information, and fear about side effects of contraceptive method. Studies show that pregnancies taking place within 24 months of previous birth have higher risk of adverse outcome like abortion, premature labour, postpartum hemorrhage, low birth weight babies, fetal loss, and maternal death. Apart from lactational amenorrhea, the methods which can be used by the women during postpartum period are barrier methods, progesterone only pills, sterilization (puerperal tubectomy) and IUCD (postpartum IUCD). IUCD insertion has many advantages over other methods like simplicity, minimal motivation, reversibility, free of cost availability, virtually no systemic side-effects, and high continuation rate. Insertion of IUCD in postpartum period has additional advantages of safety due to blunt insertion technique, and certainty of non-pregnancy of woman. Integrating IUCD insertion with delivery services optimizes opportunities for women to obtain an appropriate long term, reversible family planning method before returning home. Also it is seen that women are highly motivated and receptive to accept family planning methods during the postpartum period and this is the best time when a woman is in
Journal of Evolution of medical and Dental Sciences, 2013
BACKGROUND: Due to active involvement of fetal system in regulation of amniotic fluid volume, AFI... more BACKGROUND: Due to active involvement of fetal system in regulation of amniotic fluid volume, AFI has been identified as indicator of intrauterine fetal status. USG has revolutionized the process of assessment of amniotic fluid thus becoming an integral part of fetal surveillance. Polyhydramnios is an obstetrical condition associated with significant perinatal and maternal morbidity and mortality. In a low resource health facility as India with poor coverage of antenatal care and malnutrition it still becomes more important to screen pregnancies for such high risk factors. AIMS: 1. To study incidence of polyhydramnios. 2. To identify major etiological factors of polyhydramnios. 3. To study perinatal outcome. SETTINGS AND DESIGN: A hospital based cross section study for duration from 1 st May 2009 to 31 st October 2010. MATERIAL & METHOD: All the cases identified as polyhydramnios according to AFI in four pocket were included in the study. The cases identified as having polyhydramnio...
Background : The study was conducted to compare post-placental intrauterine contraceptive device ... more Background : The study was conducted to compare post-placental intrauterine contraceptive device insertion with immediate post partum IUCD in terms of acceptance, safety and expulsion in vaginal deliveries. Methods : This was a prospective longitudinal study. 397 willing women were inserted PPIUCD out of which 305 were in post placental period while 92 in immediate post partum period. Outcomes were studied at 6 weeks. Results : 76.8% of PPIUCD insertions were post placental whereas only 23.17% were in the immediate postpartum period. 83.38% of clients returned for follow-up whereas 16.12% of clients were lost during the study. In the post placental group,89.5% of women retained their IUCD after 6 weeks of insertions, while in the immediate postpartum IUCD insertion group only 34.14% retained the IUCD at follow-up visit.(p<<<0.0001) Conclusion : Expulsion rates are more in immediate post partum IUCD than post placental IUCD therefore it is better to insert CuT immediately a...
Journal of Evolution of medical and Dental Sciences, 2013
Heterotopic pregnancy is rare and its continuation as secondary abdominal pregnancy is even rarer... more Heterotopic pregnancy is rare and its continuation as secondary abdominal pregnancy is even rarer. A patient who had received ovulation induction presented with history of expulsion of four foetuses followed by abdominal distension and pain in abdomen. Ultrasound was suggestive of rudimentary horn pregnancy. She was kept on conservative management and at 33 weeks, emergency laparotomy was done. She had secondary abdominal pregnancy without hemoperitoneum, receiving vascular supply from ruptured rudimentary horn. Rudimentary horn was removed and patient was discharged successfully with live and healthy baby.
Journal of Evolution of medical and Dental Sciences, 2013
This work is a cross sectional study at a tertiary care centre done over a duration of one year w... more This work is a cross sectional study at a tertiary care centre done over a duration of one year with the aim to determine major indications and incidence of obstetric ICU admissions, to find out duration of ICU stay and determine maternal outcome. The three most common indications of Obstetric ICU admission were haemmorrhage followed by hypertensive disorders and iron deficiency anemia.The mean duration of ICU stay was 6.1 days. Maternal mortality was 6.54 % of the total obstetric patients admitted to our ICU. To conclude , establishment of dedicated obstetric ICU at tertiary care centre with knowledge , familarity, experience and expertise of an obstetrician and special team would be the best place to monitor and treat a critically ill obstetric patient which will reduce the maternal morbidity and mortality.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variabl... more Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during the present pregnancy. It affects 7% of all pregnancies worldwide and in India it ranges from 6 to 9% in rural and 12 to 21% in urban area. The aim of this study was to compare the DIPSI criteria with the two-step method (Carpenter and Couston criteria.) and to study merits and demerits of one step and two step tests for GDM.Methods: A total 400 pregnant women of gestational age between 24-28 weeks attending antenatal clinic at this study tertiary care center were enrolled in this study. 200 pregnant women were enrolled in each of the study group (Group I OGTT and Group II DIPSI).Results: In Group I (OGTT) screening 47 (23.5%) were tested positive. In Group II cases, screening test results were found positive among 44 (22%). Out of 95 high-risk pregnant women 38 (40%) were positive for GDM by OGTT and 34 (35.78%) were positive by DIPSI. O...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy.... more Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. Aim of this study was to identify thyroid dysfunction as a maternal health problem. Objective of this study was to study the maternal outcomes in these patients.Methods: The main source of data are the patients admitted in Sultania Zanana Hospital, GMC Bhopal. The study was an observational prospective study conducted from March 2018 to February 2019.Results: The present study was conducted in department of obstetrics and gynecology, Gandhi Medical College and associated Sultania Zanana Hospital Bhopal for the period of 1 year. The study could enroll 400 females fulfilling the inclusion criteria during the study period.Conclusions: In developing countries like India where there is prominent micronutrient deficiency, iodine deficiency further aggravates the condition and carries a great potential to show deleterious impacts on maternal and fetal outcomes, thus serving a major health prob...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: Anemia during pregnancy is a global public health challenge facing the world today. A... more Background: Anemia during pregnancy is a global public health challenge facing the world today. Among the South Asian countries, WHO estimate that India has the highest prevalence of anemia in pregnancy. Prevalence of anemia in pregnant Indian women is 49.7%, against the global prevalence of 41.8% (WHO 2008). In India, the prevalence of anemia is high because of ignorance, poverty, fewer intakes of iron, folic acid and food sources and gender bias significantly contribute to this high prevalence. Hence, this study aims to identify the risk factors and red cell morphological pattern that contribute to the presence and severity of anemia among pregnant women at the Sultania Zanana hospital, Gandhi Medical College Bhopal.Methods: The present study was conducted in Department of Obstetrics and Gynaecology, Sultania Zanana Hospital, Gandhi Medical College, Bhopal, Madhya Pradesh, India. The study included all pregnant women at third trimester who was admitted at Sultania Zanana hospital,...
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 2020
BACKGROUND:Anemia during pregnancy is a global public health challenge facing the world today. It... more BACKGROUND:Anemia during pregnancy is a global public health challenge facing the world today. It is estimated that around 2 billion people, 30% of the world population are affected with the majority coming from the developing world. AIM:This study was conducted to assess the prevalence of anaemia and its associated morbidity amongst pregnant females. MATERIALAND METHOD: The present study was a hospital- based observational study that was conducted in Department of Obstetrics and Gynaecology, Sultania Zanana Hospital ,Gandhi Medical College, Bhopal ,Madhya Pradesh, India and included all the pregnant women in third trimester of pregnancy with haemoglobin levels less than 7 who were admitted between January 2016 to December 2016. Data were analysed using SPSS v20. RESULT: A total of ve hundred cases were enrolled for the study.Most were 21-35 year old (74.2%) followed by less than 20 year old subjects (18.8%). Anaemia was more prevalent among rural population as compared to urban po...
Journal of Evolution of medical and Dental Sciences, Oct 10, 2013
IUGR is one of the most serious challenges in both developed and developing contraries. It is the... more IUGR is one of the most serious challenges in both developed and developing contraries. It is the single most important factor that determines in chances of child survival. In our country PGRF remain one of the commonest cause of neonates morbidity and mortality 30% of neonatal death are done to IUGR. Despite of all efforts by government 100% antenatal care is poor but women are seeking health facility for delivery at time ever more important to identify such high risk pregnancy and manage for better met and fetal examination (one step) in 3 rd trimester can be used as a screening procedure for detection of IUGR babies. MATERIAL AND METHODS: all pregnant women coming to the facility diagnosed to have IUGR by clinical method (SFH, AG, clinical assessment of liquor) were included in the study for duration of one year. Maternal and fetal outcome was noted in terms of mode of delivery and neonatal death, still birth, SGA, AGA. Apgar score of all the babies was noted to assess morbidity. OBSERVATION: Of the total antenatal women 200 were identify as IUGR by clinical method out of which most of were from age group 21-25 years comprising 72.4% of total cases. Maternal weight and height influence weight of the babies 75% IUGR babies were noted in height less than 145 cm. 78.5% were unbooked and 64 belong to rural population. various risk maternal factors like hypertensive disorder 26%, anemia 16.5%, previous history of IUGR 9%, antepartum haemorrhage 6%, diabetes 1%, rh negative 4.5%, heart disease 1%, recurrent abortion 5% in 17% no identified risk factors were found, 80% were delivered vaginal, 67.5% babies were SGA after birth as assessed by clinical method, 68%, had Apgar score less than 7. Perinatal mortality constituted 27.3% of the babies. DISCUSSION: Intrauterine growth restriction is one of the common abnormality encountered by the obstetrician, when present it increases perinatal morbidity and mortality. it is a multifactorial disease with varying degree of severity as in our study the noted 68% of babies with Apgar less than 7 and only 32 had Apgar more than 7 with perinatal mortality of 27.3%. IUGR per se is a major problem in India, nearly million low birth weight babies are born annually in India and it account for more than half of neonatal death. This is evidenced in our study that we were able to screen and detect 67.5% of babies who were SGA out of total screen as IUGR. This study also emphasizes the fact that IUGR as cause of neonatal morbidity and mortality can be reduced if proper antenatal care prompting early detection of high risk factor and IUGR is done. One step method of clinical assessment of IUGR can be included in maternal health programs focusing on early detection of IUGR and associated maternal risk during antenatal period and early referral to more complete health care centres where they can be benefited by more sophisticated diagnostic and therapeutic methodology such as colour doppler and ultrasound. INTRODUCTION: IUGR is one of the most serious challenges in both developed and developing countries. It is the single most important factor that determines the chances of child survival.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: The objective is to determine the knowledge, attitude and preventive practice of wome... more Background: The objective is to determine the knowledge, attitude and preventive practice of women above 45 years old.Methods: It is a cross-sectional analytical study of 100 women above 45 years of upper class women. The interview schedule consisted of 4 parts including questions about knowledge, attitude and practice (KAP) and also demographic questions.Results: A significant relationship between the score of preventive practice and all the following parameters was found: level of education, hearing about osteoporosis, knowledge score, perceived barrier to preventive actions and perceived seriousness of osteoporosis.Conclusions: Inaccurate or insufficient knowledge and their negative attitude to the preventive actions and their weak practice in case of prevention, it is the responsibility of health policymakers and medical associations to plan for osteoporosis education and prevention initiatives.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2013
India is the second most populous country in the world, sustaining 17.01% of world population on ... more India is the second most populous country in the world, sustaining 17.01% of world population on 2.4% of world's surface area. According to Census 2011 the population of India on 1 March 2011 was 1,210,193,422. In spite of availability of wide range of contraceptives, the unmet need for family planning is estimated to be 12.8%. The common reasons for unmet need are unsatisfactory services, lack of information, and fear about side effects of contraceptive method. Studies show that pregnancies taking place within 24 months of previous birth have higher risk of adverse outcome like abortion, premature labour, postpartum hemorrhage, low birth weight babies, fetal loss, and maternal death. Apart from lactational amenorrhea, the methods which can be used by the women during postpartum period are barrier methods, progesterone only pills, sterilization (puerperal tubectomy) and IUCD (postpartum IUCD). IUCD insertion has many advantages over other methods like simplicity, minimal motivation, reversibility, free of cost availability, virtually no systemic side-effects, and high continuation rate. Insertion of IUCD in postpartum period has additional advantages of safety due to blunt insertion technique, and certainty of non-pregnancy of woman. Integrating IUCD insertion with delivery services optimizes opportunities for women to obtain an appropriate long term, reversible family planning method before returning home. Also it is seen that women are highly motivated and receptive to accept family planning methods during the postpartum period and this is the best time when a woman is in
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Papers by Juhi Agarwal