Obstetrics and Gynecology
M. Madhubala; Mansi Shukul; C. Kasthuri
Volume 6, Issue 4 , August 2021, , Pages 167-173
Abstract
Background & Objective: Uterine fibroids (UF) in pregnancy is a condition, where symptomatic or asymptomatic fibroids in the uterine cavity may cause complications in pregnancies. Placental abruption and preterm labor, occurs in late pregnancy, postpartum hemorrhage, caesarean section and retained ...
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Background & Objective: Uterine fibroids (UF) in pregnancy is a condition, where symptomatic or asymptomatic fibroids in the uterine cavity may cause complications in pregnancies. Placental abruption and preterm labor, occurs in late pregnancy, postpartum hemorrhage, caesarean section and retained placenta in perinatal period. This study aimed to reckon whether the surgical Caesarean myomectomy is still a gold standard in myoma removal in pregnant women.Materials & Methods: This study was retrospectively conducted in pregnant women deliveries with uterine fibroids who underwent Myomectomy with lower segment caesarean section (LSCS). The caesarean myomectomy cases were compared with LSCS alone controls in 1:2 ratio. The primary outcome is to minimize blood loss and need for blood transfusion. The secondary outcome is the length of surgery duration and hospital stay.Results: The outcome of case and control compared was 43 caesarean myomectomy with LSCS as case group and 86 LSCS Alone as control group. The incidence of hemorrhage in case group was 10 out of 43 while control was 2 out of 86 (2.32%) with P-value of 0.0017. The secondary outcome was the length of surgery duration and hospital stay which were found statistically significant between the case and control groups, with P-value = 0.0001 and 0.0072, respectively.Conclusion: Caesarean Myomectomy can be the effective surgical option to enucleate uterine myoma, and preserve uterus and jettison from eventful or symptomatic uterine fibroids. To have the chances for prevention of immediate or interval - myomectomy / hysterectomy and control of post-partum menstrual over bleeding.
Obstetrics and Gynecology
Madhubala Manickavasagam
Volume 6, Issue 2 , March 2021, , Pages 57-64
Abstract
Background and Objective: Anemia in Pregnancy (AIP) causes many obstetric complications. Pregnant women’s awareness and knowledge play a pivotal role in management and prevention of AIP.Methods: The questionnaire survey was conducted among 138 first trimester pregnant women visiting the obstetrics ...
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Background and Objective: Anemia in Pregnancy (AIP) causes many obstetric complications. Pregnant women’s awareness and knowledge play a pivotal role in management and prevention of AIP.Methods: The questionnaire survey was conducted among 138 first trimester pregnant women visiting the obstetrics and gynaecology department for antenatal care on their first appointment. The diagnosed participants’ knowledge, awareness and management potential about AIP was assessed.Results: The mean age was 26.9 and 24.2 years in AIP and non-anemia in pregnancy NAIP groups, respectively. First trimester early week’s appointment was 38.3% and 37.6% of AIP and NIAP groups, respectively. AIP compared to parity (χ2 = 3.0739) and gestation age (χ2 = 0.8435) was not significant at P-value<0.05. According to WHO definition, AIP was reported in 49.2% of the study population involving 30.4% of urban and 18.8% of rural population. The knowledge and awareness of pregnant women towards anemia in pregnancy was not significant with eleven predictor’s odds ratio. However, both of the groups, 60.3% of the AIP and 46.2% of the NAIP cases were aware of the anemia-related complications during pregnancy.Conclusions: First trimester anemia in pregnancy was a prominent health burden in spite of available resources and awareness programmes. There was a sensitization lacunae to rule out the misconception and the belief. A healthy state of mind and practice among women shall be instrumental in bringing about an improved perception of AIP and its prevention.
Obstetrics and Gynecology
Madhubala Manickavasagam
Volume 5, Issue 2 , October 2020, , Pages 57-60
Abstract
Background and Objective: Management of caesarean myomectomy (CM) in lower uterine segment obstruction is a hard process. Here I present a pregnant woman with multiple fibroid pregnancy and an obstructing intramural fibroid in the lower segment. The CM procedure was modified here with initially excision ...
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Background and Objective: Management of caesarean myomectomy (CM) in lower uterine segment obstruction is a hard process. Here I present a pregnant woman with multiple fibroid pregnancy and an obstructing intramural fibroid in the lower segment. The CM procedure was modified here with initially excision of obstructing myoma and delivery of baby.Case Presentation: A primigravida woman visited emergency room with abdominal pain at 22 week gestation, receiving antenatal care elsewhere. The emergency abdomen USG showed multiple fibroids in pregnancy with a huge obstructing fibroid in lower segment and a breech presentation with no anomalies. Comparing earlier USG reports exposed that the multiple fibroids were growing across the gestation weeks along the developing fetus. The mother was followed for watchful expectancy till 37 weeks gestation and delivery was planned as elective LSCS. Cesarean myomectomy was carried out through initial excision of lower uterine segment myoma to remove the obstruction, and then deliver the baby through the same incision.Conclusion: Here the cesarean myomectomy procedure was altered from a regular one, featuring preliminary myomectomy of uterine fibroid in the lower segment, and then delivering the baby and myomectomies again. The outcome was delivering a live baby with hemostasis in a case, with multiple and large fibroids.
