P. Reddi Rani

Endometriosis in abdominal scars - review of 27 cases

Twenty‐seven cases of endometriosis in abdominal scars seen over a 10‐year period have been reviewed. Multiparous women within the age group of 25–35 years were affected more frequently. Hysterotomy for termination of midterm pregnancy was the most common surgical procedure done prior to the occurrence of scar endometriosis. Associated pelvic endometriosis was present in 25.9% of the cases. Treatment of choice is complete surgical excision. Progestogen therapy appears to be less effective. Good technique and proper care during surgery may help in preventing this complication.

Postural orthostatic tachycardia syndrome complicating pregnancy: a case report with review of literature

Postural orthostatic tachycardia syndrome (POTS) affects women of child-bearing age. There are little reported data on the outcomes of pregnancy in women with POTS. The most common mode of delivery reported in the literature is the caesarean section. Here we describe a woman with POTS who delivered vaginally without any complications and present a comprehensive review of the literature on pregnancy in POTS.

Early detection of IUGR: can it prevent stillbirth?

Maternal mortality in India is decreasing with the advances in health care facilities, increase in the number of hospital deliveries, improvement in the transport facilities ect. But unlike the drastic decrease in maternal mortality perinatal mortality has decreased only slightly. Stillbirth can be because of intrapartum causes or antepartum causes. Half of all stillbirths happen during the intrapartum period in the developing countries. Whereas in developed countries antepatum fetal deaths are the major contributors of perinatal mortality. A study of the contributing causes for stillbirth could reduce the incidence if preventable cause for stillbirth is present, because fetal deaths due to unexplained causes are difficult to avoid.

A prospective randomized trial to compare side effects of early versus late removal of Foley’s catheter and vaginal pack following vaginal hysterectomy

Background: There is a controversy about the ideal time for removal of catheter and vaginal pack following vaginal hysterectomy. The present study was undertaken to compare post-operative morbidity in early and late removal of Foley’s catheter and vaginal pack. The aim of this study is to compare post-operative morbidity in early and late removal of Foley’s catheter and vaginal pack following vaginal hysterectomy. Methods: This was a prospective randomized study with n=100 of those women who were undergoing vaginal hysterectomy with or without pelvic floor repair and fulfilled the inclusion criteria. After informed written consent, they were assigned to Foley’s catheter and vaginal pack removal group in 6 hours (group I, n=50) or 24 hours removal group (group II, n=50). Primary parameters used to assess were urine routine and microscopy, urine culture and sensitivity on post-operative day 2, need for re-catheterization and repacking, febrile morbidity, ambulation, vault infection and post-operative hospital stay duration were analyzed in both groups. Results: Febrile morbidity was found in 6% and 8%, Positive urine culture was found in 10% and 20%, Rate of recatheterization was 10% in group I and group II respectively. Vaginal bleeding after pack removal and repacking was in 6% in group I whilst none had in group II. Conclusions: Early removal was associated with less incidence of urinary tract infection, and increased rate of recatheterization and repacking. Needs larger comparative studies to support the practice of early removal.

Isolated oligohydramnios: effects on obstetric and perinatal outcome

Background: Outcome of oligohydramnios has been studied at a large. Varying results have been projected in each study. This study has been done to establish the obstetric and perinatal outcome in pregnancy associated with oligohydramnios as compared to women with normal liquor. Methods: This was a prospective case controlled study done which included 100 women with oligohydramnios who were compared with 100 women with normal liquor. Maternal and perinatal outcome was compared between the two groups. Results: There was a significant difference in the obstetric and perinatal outcomes among the study and control groups. Significant variation was seen in the obstetric outcome with regards to the incidence of induction of labor and mode of delivery (by caesarean section). Both were increased among the study group as compared to the control group. CTG changes, meconium stained liquor, neonatal admissions and observations were more among the study group as compared to control group. Conclusions: Athough there is an increased rate of caesarean section, NICU admission and observation, thick meconium stained liquor and NST changes there is no significant increase in the perinatal morbidity and mortality.