Vani Aditya - Academia.edu (original) (raw)
Papers by Vani Aditya
Background The overall incidence of trauma during pregnancy is about 5 to 7%. Among the different... more Background The overall incidence of trauma during pregnancy is about 5 to 7%. Among the different injuries sustained, trauma to the vulva has not been reported. Even outside obstetrics, traumatic vulvar hematomas are rare. The incidence is not known and literature is limited to the reported cases. The present case addresses the issues related to the management of non obstetric traumatic vulvar hematoma in an obstetric patient at term gestation. Case A gravida 5 woman presented at term gestation with a traumatic vulvar hematoma which was successfully managed by emergency incision and drainage. An uneventful vaginal delivery ensued thereafter.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Antepartum haemorrhage is an obstetric emergency contributing to a significant percen... more Background: Antepartum haemorrhage is an obstetric emergency contributing to a significant percentage of perinatal and maternal morbidity and mortality. Approximately 30% of maternal deaths are caused by ante-partum haemorrhage. In spite of a lot of improvement in antenatal care and intrapartum surveillance, antepar-tum haemorrhage has not reduced. Present study was conducted to assess the causes of APH and to compare the fetomaternal outcome among placenta previa and abruptio placenta group.Methods: The study was conducted in BRD medical college Gorakhpur, over a period of 1 year (October 2019 to September 2020) in which 100 cases of APH were taken and classified into placenta previa and abruptio placenta group and their fetomaternal outcome were compared.Results: In our study, out of 100 cases of APH 69% cases were of placenta previa followed by abruptio placen-ta in 29% cases and rest 2% cases were unclassified APH. Multigravida is the major risk factor in both placenta previa an...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: The objective of this study was to study the maternal and perinatal outcome of pregna... more Background: The objective of this study was to study the maternal and perinatal outcome of pregnancy complicated by obstetric cholestasis.Methods: This prospective observational study included 80 cases, diagnosed as obstetric cholestasis on the basis of symptoms of persistent pruritus (generalized or localized), biochemical evidence of altered liver function test and excluding other liver and skin disorder. Medical treatment and active management (fetal surveillance and termination of pregnancy at 37-38 weeks) were offered to all. Maternal and perinatal outcome were studied.Results: Incidence of obstetric cholestasis was 1.9%. Majority of women (55%) were primigravida and recurrence rate was 61.1% among multiparous women. Pruritus (generalized) was the cardinal symptoms in 90% patients and mostly (88.7%) presented and diagnosed after 28 weeks i.e. in third trimester. A total of 43.7%women had caesarean section (CS) which was quite high incidence. Most common pregnancy complications ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2013
Shoulder dystocia is one of the most difficult complications of labor that is often unpredictable... more Shoulder dystocia is one of the most difficult complications of labor that is often unpredictable and hence unpreventable. In most cases, the cause is dystocia from the bony pelvis. The major brunt of complications is borne by the fetus. In neglected cases, grave maternal complications like obstructed labor and rupture of uterus may result. Very rarely, the reverse can also occur; uterine rupture may lead to shoulder dystocia. The dystocia results from the soft tissue of the ruptured uterus itself. The present case is reported to emphasize the importance of early recognition of this condition. CASE REPORT A gravida 3 para 2 woman presented in obstetrics emergency with spontaneous delivery of head six hours back , at home, after being in labor for 8 to 10 hours. Just after the delivery of head, pains subsided and the trunk failed to deliver. Within 15 minutes, she was rushed to a nearby primary health centre where she was diagnosed as a case of ruptured uterus with intrauterine death. No further attempt was made to deliver the trunk and she was referred to our tertiary care centre. Her first delivery was by cesarean that was done for fetal distress. The cesarean was done at a private hospital by a general surgeon. Birth weight of the baby was 2.6 kilograms. Second was an
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, Jul 26, 2017
Background: Different spectrum of liver disease can affect outcome of pregnancy. The incidence of... more Background: Different spectrum of liver disease can affect outcome of pregnancy. The incidence of liver disorders in pregnancy varies in different parts of the world. The present study was designed to see the incidence, spectrum, and outcome of liver disease in pregnancy. Methods: All pregnant women with deranged liver profile, attending antenatal clinic and labour room in the department of Obstetrics and Gynecology of BRD Medical College over the period of one year (August 2015 to July 2016) were included in the study. Enrolled cases were followed up till discharge in respect to maternal and fetal outcome. Results: Liver disease was found in 214 (2.37%) cases out of 9011 pregnancies. Pregnancy specific liver disease was the most common type (85.98%). Among pregnancy specific liver disease Hypertensive disorders of pregnancy was the commonest abnormality (66.35%). Rest were Cholestasis, Acute viral hepatitis, Chronic liver disease, Hyperemesis gravidarum, Acute fatty liver of pregnancy. Out of 214, 22 patients dropped out. Overall maternal and perinatal mortality were 13.02% and 29.17% respectively. Conclusions: Liver disease in pregnancy is not uncommon and it can seriously affect pregnancy outcome if not treated properly on time. Early diagnosis (by clinical suspicion and blood investigation) and timely intervention can improve maternal and fetal outcome in pregnancy with liver disease.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: The current outburst of Indian population (1.21 billion as per census 2011) is becaus... more Background: The current outburst of Indian population (1.21 billion as per census 2011) is because of the lack of awareness and acceptance of contraception in the immediate postpartum period. Postpartum intrauterine contraceptive device (PPIUCD) insertion can do wonders and curb this unmet need of family planning if good counselling and proper insertion techniques are followed. Methods: The present study was carried among 526 women in the department of obstetrics and gynaecology of Nehru Hospital in BRD medical college Gorakhpur, India. Intrauterine contraceptive device (IUCD) was inserted in 424 women in PPIUCD group and in 102 women in interval IUCD group after taking proper consent and following the WHO medical eligibility criteria for contraceptive use (MEC). Follow-up was done at 6 weeks and 6 months. Results: The acceptance rate of PPIUCD was 30.34% as compared to 18% in interval IUCD group (p-value <0.05). The chief reason for declining the use of IUCD was fear of excessive pain and bleeding (26.3%). Long term reversible method (32%) was the main reason given for accepting IUCD. There was no perforation or any other major complication at the time of insertion in both the groups. Rate of expulsion was 5.7% in PPIUCD and 2.22% in interval IUCD group p-value (>0.05). Conclusions: PPIUCD is a safe, effective, feasible and reversible method of contraception. It should be made a part of family health care programmes in India.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Vaginal route is considered to be the method of choice for removal of uterus and, in ... more Background: Vaginal route is considered to be the method of choice for removal of uterus and, in the absence of gross pelvic disease, can be carried out in most patients. Recent studies have shown that less than one-third of hysterectomies are performed vaginally. This could be due to technical difficulties occurring while operating in the narrow surgical field. This study was taken up to find out the easier alternatives in securing pedicles by using Electrosurgical Bipolar Vessel Sealer in Vaginal Hysterectomy.Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, BRD Medical College, Gorakhpur over a period of one year i.e. July 15 to June 16. A total of 62 patients posted for vaginal hysterectomy for benign conditions were enrolled after informed consent. Results were recorded under headings of procedure time (min), blood loss (ml), major intra-operative complications and post operative complications, post-operative pain (on VAS)...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Pre eclampsia has remained a significant public health threat in both developed and d... more Background: Pre eclampsia has remained a significant public health threat in both developed and developing countries contributing to maternal and perinatal morbidity and mortality globally. Vitamin D has direct influence on molecular pathways proposed to be important in the pathogenesis of pre eclampsia, yet the vitamin D-pre eclampsia relation has seldom been studied. In the present study we aimed to assess the association of vitamin D deficiency with the occurrence of pre eclampsia. If indeed vitamin D deficiency is related to pre eclampsia, this correlation can inform future studies, which hopefully will ultimately lead to a decrease in the incidence of pre eclampsia hence a decrease in adverse maternal and fetal outcomes. Methods: We conducted a comparative cross sectional study carried out for a period of one year from August 2014 to July 2015. A total of 384 patients were selected. 192 pre eclamptic and 192 non pre eclamptic pregnant patients aged 16-45 years attending in-patient department of Obstetrics and Gynaecology BRD Medical college Gorakhpur were included in the study. Results: About 82.8% of pre eclamptic and 31.25% of non pre eclamptic patients were found deficient in vitamin D. Also, severe pre eclamptic patients had more severe deficiency of vitamin D. Majority of these patients (51.78%) had very low vitamin D concentration. Conclusions: Maternal vitamin D deficiency may be an independent risk factor for preeclampsia. Vitamin D supplementation in pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being.
World Journal of Medical and Surgical Case Reports, Aug 13, 2013
Case reports in obstetrics and gynecology, 2014
Facial paralysis is the most frequent unilateral cranial nerve pathology affecting pregnant popul... more Facial paralysis is the most frequent unilateral cranial nerve pathology affecting pregnant population 2 to 4 times more often than the nonpregnant population. There exists an association with preeclampsia but this has largely been overlooked. Clinicians often dismiss it for idiopathic palsy as seen in the present case. A 30-year-old woman, Gravida 4, Para 3, presented at 26 weeks pregnancy with complaints of facial weakness, blurring of vision, altered taste sensation, increased noise sensitivity for 1 month, headache since 18 days, and vomiting since 2-3 days. Her pulse was 90/min, BP was 170/120, and RR was 18/min. Uterus was 18 weeks size and proteinuria++ was present. Ultrasonography revealed a 26 weeks fetus, severe bradycardia, and absent liquor. HELLP syndrome was diagnosed after investigations. Six units of fresh frozen plasma were transfused. An informed decision for termination of pregnancy was made. She delivered a 450 gram stillborn. The third stage was complicated with...
Background The overall incidence of trauma during pregnancy is about 5 to 7%. Among the different... more Background The overall incidence of trauma during pregnancy is about 5 to 7%. Among the different injuries sustained, trauma to the vulva has not been reported. Even outside obstetrics, traumatic vulvar hematomas are rare. The incidence is not known and literature is limited to the reported cases. The present case addresses the issues related to the management of non obstetric traumatic vulvar hematoma in an obstetric patient at term gestation. Case A gravida 5 woman presented at term gestation with a traumatic vulvar hematoma which was successfully managed by emergency incision and drainage. An uneventful vaginal delivery ensued thereafter.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Antepartum haemorrhage is an obstetric emergency contributing to a significant percen... more Background: Antepartum haemorrhage is an obstetric emergency contributing to a significant percentage of perinatal and maternal morbidity and mortality. Approximately 30% of maternal deaths are caused by ante-partum haemorrhage. In spite of a lot of improvement in antenatal care and intrapartum surveillance, antepar-tum haemorrhage has not reduced. Present study was conducted to assess the causes of APH and to compare the fetomaternal outcome among placenta previa and abruptio placenta group.Methods: The study was conducted in BRD medical college Gorakhpur, over a period of 1 year (October 2019 to September 2020) in which 100 cases of APH were taken and classified into placenta previa and abruptio placenta group and their fetomaternal outcome were compared.Results: In our study, out of 100 cases of APH 69% cases were of placenta previa followed by abruptio placen-ta in 29% cases and rest 2% cases were unclassified APH. Multigravida is the major risk factor in both placenta previa an...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: The objective of this study was to study the maternal and perinatal outcome of pregna... more Background: The objective of this study was to study the maternal and perinatal outcome of pregnancy complicated by obstetric cholestasis.Methods: This prospective observational study included 80 cases, diagnosed as obstetric cholestasis on the basis of symptoms of persistent pruritus (generalized or localized), biochemical evidence of altered liver function test and excluding other liver and skin disorder. Medical treatment and active management (fetal surveillance and termination of pregnancy at 37-38 weeks) were offered to all. Maternal and perinatal outcome were studied.Results: Incidence of obstetric cholestasis was 1.9%. Majority of women (55%) were primigravida and recurrence rate was 61.1% among multiparous women. Pruritus (generalized) was the cardinal symptoms in 90% patients and mostly (88.7%) presented and diagnosed after 28 weeks i.e. in third trimester. A total of 43.7%women had caesarean section (CS) which was quite high incidence. Most common pregnancy complications ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2013
Shoulder dystocia is one of the most difficult complications of labor that is often unpredictable... more Shoulder dystocia is one of the most difficult complications of labor that is often unpredictable and hence unpreventable. In most cases, the cause is dystocia from the bony pelvis. The major brunt of complications is borne by the fetus. In neglected cases, grave maternal complications like obstructed labor and rupture of uterus may result. Very rarely, the reverse can also occur; uterine rupture may lead to shoulder dystocia. The dystocia results from the soft tissue of the ruptured uterus itself. The present case is reported to emphasize the importance of early recognition of this condition. CASE REPORT A gravida 3 para 2 woman presented in obstetrics emergency with spontaneous delivery of head six hours back , at home, after being in labor for 8 to 10 hours. Just after the delivery of head, pains subsided and the trunk failed to deliver. Within 15 minutes, she was rushed to a nearby primary health centre where she was diagnosed as a case of ruptured uterus with intrauterine death. No further attempt was made to deliver the trunk and she was referred to our tertiary care centre. Her first delivery was by cesarean that was done for fetal distress. The cesarean was done at a private hospital by a general surgeon. Birth weight of the baby was 2.6 kilograms. Second was an
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, Jul 26, 2017
Background: Different spectrum of liver disease can affect outcome of pregnancy. The incidence of... more Background: Different spectrum of liver disease can affect outcome of pregnancy. The incidence of liver disorders in pregnancy varies in different parts of the world. The present study was designed to see the incidence, spectrum, and outcome of liver disease in pregnancy. Methods: All pregnant women with deranged liver profile, attending antenatal clinic and labour room in the department of Obstetrics and Gynecology of BRD Medical College over the period of one year (August 2015 to July 2016) were included in the study. Enrolled cases were followed up till discharge in respect to maternal and fetal outcome. Results: Liver disease was found in 214 (2.37%) cases out of 9011 pregnancies. Pregnancy specific liver disease was the most common type (85.98%). Among pregnancy specific liver disease Hypertensive disorders of pregnancy was the commonest abnormality (66.35%). Rest were Cholestasis, Acute viral hepatitis, Chronic liver disease, Hyperemesis gravidarum, Acute fatty liver of pregnancy. Out of 214, 22 patients dropped out. Overall maternal and perinatal mortality were 13.02% and 29.17% respectively. Conclusions: Liver disease in pregnancy is not uncommon and it can seriously affect pregnancy outcome if not treated properly on time. Early diagnosis (by clinical suspicion and blood investigation) and timely intervention can improve maternal and fetal outcome in pregnancy with liver disease.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: The current outburst of Indian population (1.21 billion as per census 2011) is becaus... more Background: The current outburst of Indian population (1.21 billion as per census 2011) is because of the lack of awareness and acceptance of contraception in the immediate postpartum period. Postpartum intrauterine contraceptive device (PPIUCD) insertion can do wonders and curb this unmet need of family planning if good counselling and proper insertion techniques are followed. Methods: The present study was carried among 526 women in the department of obstetrics and gynaecology of Nehru Hospital in BRD medical college Gorakhpur, India. Intrauterine contraceptive device (IUCD) was inserted in 424 women in PPIUCD group and in 102 women in interval IUCD group after taking proper consent and following the WHO medical eligibility criteria for contraceptive use (MEC). Follow-up was done at 6 weeks and 6 months. Results: The acceptance rate of PPIUCD was 30.34% as compared to 18% in interval IUCD group (p-value <0.05). The chief reason for declining the use of IUCD was fear of excessive pain and bleeding (26.3%). Long term reversible method (32%) was the main reason given for accepting IUCD. There was no perforation or any other major complication at the time of insertion in both the groups. Rate of expulsion was 5.7% in PPIUCD and 2.22% in interval IUCD group p-value (>0.05). Conclusions: PPIUCD is a safe, effective, feasible and reversible method of contraception. It should be made a part of family health care programmes in India.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Vaginal route is considered to be the method of choice for removal of uterus and, in ... more Background: Vaginal route is considered to be the method of choice for removal of uterus and, in the absence of gross pelvic disease, can be carried out in most patients. Recent studies have shown that less than one-third of hysterectomies are performed vaginally. This could be due to technical difficulties occurring while operating in the narrow surgical field. This study was taken up to find out the easier alternatives in securing pedicles by using Electrosurgical Bipolar Vessel Sealer in Vaginal Hysterectomy.Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, BRD Medical College, Gorakhpur over a period of one year i.e. July 15 to June 16. A total of 62 patients posted for vaginal hysterectomy for benign conditions were enrolled after informed consent. Results were recorded under headings of procedure time (min), blood loss (ml), major intra-operative complications and post operative complications, post-operative pain (on VAS)...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Pre eclampsia has remained a significant public health threat in both developed and d... more Background: Pre eclampsia has remained a significant public health threat in both developed and developing countries contributing to maternal and perinatal morbidity and mortality globally. Vitamin D has direct influence on molecular pathways proposed to be important in the pathogenesis of pre eclampsia, yet the vitamin D-pre eclampsia relation has seldom been studied. In the present study we aimed to assess the association of vitamin D deficiency with the occurrence of pre eclampsia. If indeed vitamin D deficiency is related to pre eclampsia, this correlation can inform future studies, which hopefully will ultimately lead to a decrease in the incidence of pre eclampsia hence a decrease in adverse maternal and fetal outcomes. Methods: We conducted a comparative cross sectional study carried out for a period of one year from August 2014 to July 2015. A total of 384 patients were selected. 192 pre eclamptic and 192 non pre eclamptic pregnant patients aged 16-45 years attending in-patient department of Obstetrics and Gynaecology BRD Medical college Gorakhpur were included in the study. Results: About 82.8% of pre eclamptic and 31.25% of non pre eclamptic patients were found deficient in vitamin D. Also, severe pre eclamptic patients had more severe deficiency of vitamin D. Majority of these patients (51.78%) had very low vitamin D concentration. Conclusions: Maternal vitamin D deficiency may be an independent risk factor for preeclampsia. Vitamin D supplementation in pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being.
World Journal of Medical and Surgical Case Reports, Aug 13, 2013
Case reports in obstetrics and gynecology, 2014
Facial paralysis is the most frequent unilateral cranial nerve pathology affecting pregnant popul... more Facial paralysis is the most frequent unilateral cranial nerve pathology affecting pregnant population 2 to 4 times more often than the nonpregnant population. There exists an association with preeclampsia but this has largely been overlooked. Clinicians often dismiss it for idiopathic palsy as seen in the present case. A 30-year-old woman, Gravida 4, Para 3, presented at 26 weeks pregnancy with complaints of facial weakness, blurring of vision, altered taste sensation, increased noise sensitivity for 1 month, headache since 18 days, and vomiting since 2-3 days. Her pulse was 90/min, BP was 170/120, and RR was 18/min. Uterus was 18 weeks size and proteinuria++ was present. Ultrasonography revealed a 26 weeks fetus, severe bradycardia, and absent liquor. HELLP syndrome was diagnosed after investigations. Six units of fresh frozen plasma were transfused. An informed decision for termination of pregnancy was made. She delivered a 450 gram stillborn. The third stage was complicated with...