Aims: To find the incidence, risk factors, morbidity and mortality in ectopic pregnancy in a tert... more Aims: To find the incidence, risk factors, morbidity and mortality in ectopic pregnancy in a tertiary center in rural Telangana. Methods: This retrospective observational study was conducted in the Department of Obstetrics and Gynecology, Mamata Medical College, Khammam, Telangana State, India, over 5 years from 2017 to 2021. Detailed informative data of all admitted and treated cases of ectopic pregnancy were collected, analyzed and discussed. Result: The incidence of ectopic pregnancy was 1.3 per 100 pregnancies and 2.5% case fatality. The majority of cases were in the 20-30 years of age group (82.5%); multipara (50%) and gestational age of ≤ 8 weeks (62.5%). History of abortion was the most common risk factor (67.5%). The classical triad of amenorrhoea, pain abdomen and bleeding per vagina was present in 45% of cases; and amenorrhea (97.5%), pain abdomen (87.5%) and vaginal bleeding (42.5%), abdominal tenderness (85%) and unstable hemodynamic (22.5%) were reported. The fallopian ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Primary vaginal cancer in a case of genital prolapse is a very rare malignancy. The usual age inc... more Primary vaginal cancer in a case of genital prolapse is a very rare malignancy. The usual age incidence is above 60 years. Likely risk factors and etiology are elderly age, smoking, low immunity, mechanical irritation and inflammation, and persistent infection with oncogenic human papillomavirus. Clinical presentation varies with the stage of the disease. Usually confused with decubitus ulcer in advanced genital prolapse. Histopathology of the biopsy specimen confirms the diagnosis. Though clinically staged imaging is required for better management and prognosis. Management modality depends on the stage, type of malignancy, comorbidity, and patient’s decision. Stage, grade, type of cancer, comorbidity, and adequate management affect the prognosis. Here we present a case of primary vaginal carcinoma in a 71 year old lady with complete genital prolapse simulating decubitus ulcer. The diagnosis was confirmed with histopathology and she was treated with radiotherapy. She died in her hom...
Journal of South Asian Federation of Obstetrics and Gynaecology
Background: Increasing the cesarean section rate with its complications is a global concern now. ... more Background: Increasing the cesarean section rate with its complications is a global concern now. High economical background, education, limited family size, comfort of both; the patient and the care provider as well as the availability of facility and advanced technology are the responsible factors for the high rate of the surgery. In an attempt to reduce the rate, World Health Organization (WHO) has introduced Robson's Ten-group Classification System (RTGCS) for auditing, analyzing, and finding the largest contributor to the surgery so that steps can be taken to limit it. Aims: (i) Finding out the group contributing more to the total cesarean section. (ii) Discussing the possible remedial measures to reduce the rate of the surgery. Materials and methods: This retrospective study was conducted in the Obstetrics and Gynaecology Department of Mamata Medical College, Khammam, Telangana State, India, over 5 years period, which included all the cesarean deliveries at and beyond 28 completed weeks of gestation. Results: Total cesarean deliveries were 778 and the rate of cesarean section was 31.39% of total deliveries. Group X of RTGCS had a maximum contribution (31.10%) followed by group V (29.43%), group II (20.95%), and group I (06.68%) to the total cesarean deliveries. Conclusion: Robson's ten-group classification system, as the preliminary step in reducing the rate of cesarean delivery, is good to find the maximum contributors to the surgery. Detailed auditing and analysis will help to limit the rate of surgery by taking necessary steps, without affecting the mother and the baby. The role of the institution and care provider is important in the success of the mission. Clinical significance: Attempt to reduce the rate of the cesarean section without compromising pregnancy outcome.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Benign multicystic mesothelioma is a rare pathology that is usually diagnosed on laparotomy for o... more Benign multicystic mesothelioma is a rare pathology that is usually diagnosed on laparotomy for other abdominal diseases. It is more common in females of reproductive age group than in males. The commonest presentation is chronic pain abdomen. Ultrasound is the usual diagnostic tool and the ovarian cyst is the commonest differential diagnosis. Both, reactive and neoplastic hypotheses are considered in the etiopathogenesis of this condition. Management of the disease constitutes complete surgical excision and follow up of the patient. Our patient, a 33 years old parous lady, reported with chronic pain abdomen and right adnexal multiloculated cystic mass. She underwent laparotomy with a provisional diagnosis of ovarian cyst. Histopathology of the excised specimen was benign multicystic mesothelioma with ovarian endometriosis. This case was presented for its rare occurrence, mimicking malignancy, the chance of local recurrence and malignant transformation requiring long term follow up.
Scholars International Journal of Obstetrics and Gynecology
Background: Pre-eclampsia affects up to 10% pregnancies worldwide and is one of the foremost caus... more Background: Pre-eclampsia affects up to 10% pregnancies worldwide and is one of the foremost causes of poor maternal and foetal outcome. The situation in India is even grave with high rate of maternal mortality due to pre-eclampsia. Though multiple risk factors are associated with pre-eclampsia, it is known that first pregnancy itself is a significant preeclamptic risk factor. Therefore, in this study we intent to gauge the effects of low dose Acetyl salicylic acid (Aspirin) among pregnant women in prevention of pre-eclampsia. Materials and Methods: This randomized controlled study was conducted in Department of Obstetrics and Gynaecology of Mamata Medical College and General Hospital. Total 100 patients were enrolled in this study. Pregnant women with and without any other pre-eclamptic risk factor consulting before the 16th week of amenorrhea were selected in the study. One group i.e. Treatment group (n=50) was given 75mg/day aspirin orally after breakfast to one week before estimated date of delivery while the other group received no aspirin. Both groups were followed for regular antenatal checkup. Results: The treatment group who received acetyl salicylic acid (aspirin), the age ranged from 20-35 years with a mean age of 24.81±3.12 years. Maximum number of cases belonged wot age group of 26-30 years. The treatment group who received acetyl salicylic acid (aspirin), the age ranged from 20-35 years with a mean age of 25.21±4.29 years. Moreover, we found pre-eclampsia in aspirin group was of lesser severity as compared to those in control group. Further, proportion wise the risk of pregnancy induced hypertension and eclampsia were also reduced with aspirin, however, these were not found statistically significant. Conclusion: Our study highlights the beneficial effect of low-dose acetyl salicylic acid in decreasing hypertension and proteinuria. This study also confirms the efficacy of acetyl salicylic acid in decreasing caesarean section, maternal mortality and morbidity.
Objective: To evaluate ovarian cysts detected in patients who had undergone previous hysterectomy... more Objective: To evaluate ovarian cysts detected in patients who had undergone previous hysterectomy and to study the clinical, pathological and surgical characteristics in these patients. Material and Methods: An observational study was conducted in the department of Obstetrics and Gynaecology, Mamata Medical College, Khammam over a period of 3 years on patients who had undergone previous hysterectomy. A detailed history, clinical presentation was taken from patients who had ovarian cysts was included in the study. The previous records, characteristics of ovarian cysts and management were evaluated in these patients. Results: A total of 700 post hysterectomy patients presented to OPD of them 66 patients identified with ovarian cysts were included in the study. Most of them (68%) underwent hysterectomy at the age of 40-50 years; abdominal hysterectomy was common mode of surgery (82%). AUB–L was the major indication for hysterectomy (44%), in 65% cases both the ovaries were preserved, p...
Journal of Dr. NTR University of Health Sciences, 2017
Introduction: Newborn birth weight is a major indicator of health. Although it is influenced by m... more Introduction: Newborn birth weight is a major indicator of health. Although it is influenced by many conditions that affect maternal and feto-placental units, several sociocultural, religious, and geographical factors cannot be ignored. Considering this, the present study was conducted in a tertiary hospital in Khammam, Telangana to determine the average birth weight in normal pregnancy at term. Materials and Methods: All the babies, born following normal pregnancy from January 2013 to June 2015, were included in this study to establish their birth weight. Babies born without being affected by any factor influencing fetal weight were considered for the study. Some exclusion criteria such as short maternal height and teenage pregnancy were considered in this study. Results: There were 633 cases in the study group, out of which 226 were primipara and 407 were multipara. Average birth weight for all cases was 2790 g. Average birth weight for the first born babies was 2770 g, whereas in later born, it was 2800 g. Average birth weight of male newborn babies was 2860 g, whereas it was 2710 g for female newborn babies. Conclusion: Abnormal birth weight leads to many complications, both immediate and remote. However, to predict and manage such complications, one must know the average newborn birth weight. This study is the first of its kind in rural Telangana.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Xanthomatous oophoritis is a rare chronic inflammation of ovary characterized histologically with... more Xanthomatous oophoritis is a rare chronic inflammation of ovary characterized histologically with infiltration of lipid laden foamy macrophages, lymphocytes, plasma cells leading to tissue destruction. Though exact cause is not known, uterine artery embolization, gloves dusting powder and altered lipid metabolism are hypothesized to cause the pathology. A 28-year-old parous lady with history of multiple laparotomies, known case of hypothyroidism under treatment and history of adequately treated pulmonary tuberculosis was diagnosed to have right ovarian dermoid cyst, while undergoing investigation for secondary infertility. On examination she had pallor, healthy abdominal scar, and small tender fixed mass in right fornix on internal examination. She was subjected to laparotomy and right salpingo oophorectomy with left salpingectomy was performed. Histopathological examination of the resected specimen revealed to be xanthomatous oophoritis of right ovary. As this condition mimics tube...
Aims: To find the incidence, risk factors, morbidity and mortality in ectopic pregnancy in a tert... more Aims: To find the incidence, risk factors, morbidity and mortality in ectopic pregnancy in a tertiary center in rural Telangana. Methods: This retrospective observational study was conducted in the Department of Obstetrics and Gynecology, Mamata Medical College, Khammam, Telangana State, India, over 5 years from 2017 to 2021. Detailed informative data of all admitted and treated cases of ectopic pregnancy were collected, analyzed and discussed. Result: The incidence of ectopic pregnancy was 1.3 per 100 pregnancies and 2.5% case fatality. The majority of cases were in the 20-30 years of age group (82.5%); multipara (50%) and gestational age of ≤ 8 weeks (62.5%). History of abortion was the most common risk factor (67.5%). The classical triad of amenorrhoea, pain abdomen and bleeding per vagina was present in 45% of cases; and amenorrhea (97.5%), pain abdomen (87.5%) and vaginal bleeding (42.5%), abdominal tenderness (85%) and unstable hemodynamic (22.5%) were reported. The fallopian ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Primary vaginal cancer in a case of genital prolapse is a very rare malignancy. The usual age inc... more Primary vaginal cancer in a case of genital prolapse is a very rare malignancy. The usual age incidence is above 60 years. Likely risk factors and etiology are elderly age, smoking, low immunity, mechanical irritation and inflammation, and persistent infection with oncogenic human papillomavirus. Clinical presentation varies with the stage of the disease. Usually confused with decubitus ulcer in advanced genital prolapse. Histopathology of the biopsy specimen confirms the diagnosis. Though clinically staged imaging is required for better management and prognosis. Management modality depends on the stage, type of malignancy, comorbidity, and patient’s decision. Stage, grade, type of cancer, comorbidity, and adequate management affect the prognosis. Here we present a case of primary vaginal carcinoma in a 71 year old lady with complete genital prolapse simulating decubitus ulcer. The diagnosis was confirmed with histopathology and she was treated with radiotherapy. She died in her hom...
Journal of South Asian Federation of Obstetrics and Gynaecology
Background: Increasing the cesarean section rate with its complications is a global concern now. ... more Background: Increasing the cesarean section rate with its complications is a global concern now. High economical background, education, limited family size, comfort of both; the patient and the care provider as well as the availability of facility and advanced technology are the responsible factors for the high rate of the surgery. In an attempt to reduce the rate, World Health Organization (WHO) has introduced Robson's Ten-group Classification System (RTGCS) for auditing, analyzing, and finding the largest contributor to the surgery so that steps can be taken to limit it. Aims: (i) Finding out the group contributing more to the total cesarean section. (ii) Discussing the possible remedial measures to reduce the rate of the surgery. Materials and methods: This retrospective study was conducted in the Obstetrics and Gynaecology Department of Mamata Medical College, Khammam, Telangana State, India, over 5 years period, which included all the cesarean deliveries at and beyond 28 completed weeks of gestation. Results: Total cesarean deliveries were 778 and the rate of cesarean section was 31.39% of total deliveries. Group X of RTGCS had a maximum contribution (31.10%) followed by group V (29.43%), group II (20.95%), and group I (06.68%) to the total cesarean deliveries. Conclusion: Robson's ten-group classification system, as the preliminary step in reducing the rate of cesarean delivery, is good to find the maximum contributors to the surgery. Detailed auditing and analysis will help to limit the rate of surgery by taking necessary steps, without affecting the mother and the baby. The role of the institution and care provider is important in the success of the mission. Clinical significance: Attempt to reduce the rate of the cesarean section without compromising pregnancy outcome.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Benign multicystic mesothelioma is a rare pathology that is usually diagnosed on laparotomy for o... more Benign multicystic mesothelioma is a rare pathology that is usually diagnosed on laparotomy for other abdominal diseases. It is more common in females of reproductive age group than in males. The commonest presentation is chronic pain abdomen. Ultrasound is the usual diagnostic tool and the ovarian cyst is the commonest differential diagnosis. Both, reactive and neoplastic hypotheses are considered in the etiopathogenesis of this condition. Management of the disease constitutes complete surgical excision and follow up of the patient. Our patient, a 33 years old parous lady, reported with chronic pain abdomen and right adnexal multiloculated cystic mass. She underwent laparotomy with a provisional diagnosis of ovarian cyst. Histopathology of the excised specimen was benign multicystic mesothelioma with ovarian endometriosis. This case was presented for its rare occurrence, mimicking malignancy, the chance of local recurrence and malignant transformation requiring long term follow up.
Scholars International Journal of Obstetrics and Gynecology
Background: Pre-eclampsia affects up to 10% pregnancies worldwide and is one of the foremost caus... more Background: Pre-eclampsia affects up to 10% pregnancies worldwide and is one of the foremost causes of poor maternal and foetal outcome. The situation in India is even grave with high rate of maternal mortality due to pre-eclampsia. Though multiple risk factors are associated with pre-eclampsia, it is known that first pregnancy itself is a significant preeclamptic risk factor. Therefore, in this study we intent to gauge the effects of low dose Acetyl salicylic acid (Aspirin) among pregnant women in prevention of pre-eclampsia. Materials and Methods: This randomized controlled study was conducted in Department of Obstetrics and Gynaecology of Mamata Medical College and General Hospital. Total 100 patients were enrolled in this study. Pregnant women with and without any other pre-eclamptic risk factor consulting before the 16th week of amenorrhea were selected in the study. One group i.e. Treatment group (n=50) was given 75mg/day aspirin orally after breakfast to one week before estimated date of delivery while the other group received no aspirin. Both groups were followed for regular antenatal checkup. Results: The treatment group who received acetyl salicylic acid (aspirin), the age ranged from 20-35 years with a mean age of 24.81±3.12 years. Maximum number of cases belonged wot age group of 26-30 years. The treatment group who received acetyl salicylic acid (aspirin), the age ranged from 20-35 years with a mean age of 25.21±4.29 years. Moreover, we found pre-eclampsia in aspirin group was of lesser severity as compared to those in control group. Further, proportion wise the risk of pregnancy induced hypertension and eclampsia were also reduced with aspirin, however, these were not found statistically significant. Conclusion: Our study highlights the beneficial effect of low-dose acetyl salicylic acid in decreasing hypertension and proteinuria. This study also confirms the efficacy of acetyl salicylic acid in decreasing caesarean section, maternal mortality and morbidity.
Objective: To evaluate ovarian cysts detected in patients who had undergone previous hysterectomy... more Objective: To evaluate ovarian cysts detected in patients who had undergone previous hysterectomy and to study the clinical, pathological and surgical characteristics in these patients. Material and Methods: An observational study was conducted in the department of Obstetrics and Gynaecology, Mamata Medical College, Khammam over a period of 3 years on patients who had undergone previous hysterectomy. A detailed history, clinical presentation was taken from patients who had ovarian cysts was included in the study. The previous records, characteristics of ovarian cysts and management were evaluated in these patients. Results: A total of 700 post hysterectomy patients presented to OPD of them 66 patients identified with ovarian cysts were included in the study. Most of them (68%) underwent hysterectomy at the age of 40-50 years; abdominal hysterectomy was common mode of surgery (82%). AUB–L was the major indication for hysterectomy (44%), in 65% cases both the ovaries were preserved, p...
Journal of Dr. NTR University of Health Sciences, 2017
Introduction: Newborn birth weight is a major indicator of health. Although it is influenced by m... more Introduction: Newborn birth weight is a major indicator of health. Although it is influenced by many conditions that affect maternal and feto-placental units, several sociocultural, religious, and geographical factors cannot be ignored. Considering this, the present study was conducted in a tertiary hospital in Khammam, Telangana to determine the average birth weight in normal pregnancy at term. Materials and Methods: All the babies, born following normal pregnancy from January 2013 to June 2015, were included in this study to establish their birth weight. Babies born without being affected by any factor influencing fetal weight were considered for the study. Some exclusion criteria such as short maternal height and teenage pregnancy were considered in this study. Results: There were 633 cases in the study group, out of which 226 were primipara and 407 were multipara. Average birth weight for all cases was 2790 g. Average birth weight for the first born babies was 2770 g, whereas in later born, it was 2800 g. Average birth weight of male newborn babies was 2860 g, whereas it was 2710 g for female newborn babies. Conclusion: Abnormal birth weight leads to many complications, both immediate and remote. However, to predict and manage such complications, one must know the average newborn birth weight. This study is the first of its kind in rural Telangana.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Xanthomatous oophoritis is a rare chronic inflammation of ovary characterized histologically with... more Xanthomatous oophoritis is a rare chronic inflammation of ovary characterized histologically with infiltration of lipid laden foamy macrophages, lymphocytes, plasma cells leading to tissue destruction. Though exact cause is not known, uterine artery embolization, gloves dusting powder and altered lipid metabolism are hypothesized to cause the pathology. A 28-year-old parous lady with history of multiple laparotomies, known case of hypothyroidism under treatment and history of adequately treated pulmonary tuberculosis was diagnosed to have right ovarian dermoid cyst, while undergoing investigation for secondary infertility. On examination she had pallor, healthy abdominal scar, and small tender fixed mass in right fornix on internal examination. She was subjected to laparotomy and right salpingo oophorectomy with left salpingectomy was performed. Histopathological examination of the resected specimen revealed to be xanthomatous oophoritis of right ovary. As this condition mimics tube...
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