Arun Mahale - Academia.edu (original) (raw)

Papers by Arun Mahale

Research paper thumbnail of Manual removal versus spontaneous delivery of the placenta at cesarean section in developing countries: a randomized controlled trial and review of literature

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, Dec 30, 2017

Cesarean section (CS) rates have increased; this is especially concerning in developing countries... more Cesarean section (CS) rates have increased; this is especially concerning in developing countries. The mode of placental delivery contributes to morbidity associated with CS and determines blood loss during CS. We aimed to compare manual removal versus spontaneous delivery of the placenta at CS. In a randomized controlled trial, 574 women admitted for primary or repeat elective CS were randomized into two groups. In group A, the placenta was manually removed, whereas in group B, the placenta was left for spontaneous delivery. Blood loss, operative and postoperative data were recorded. Blood loss was 875.2 ± 524.2 ml in group A versus 731.8 ± 426.7 ml in group B (p = .001), with a significant drop in postoperative HB (p = .015) and HCT (p = .031). In group A, odds ratios for blood loss (>1000 ml), HB drop (> 4g/dl), postpartum hemorrhage and blood transfusion were 2.581, 2.850, 2.614 and 1.665, respectively. However, the total operative time (p = .326), duration of hospital sta...

Research paper thumbnail of Caesarean section scar pregnancy: case report, literature review and illustrative images

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

A case report of exogenic caesarean section scar pregnancy which ruptured into the utero-vesical ... more A case report of exogenic caesarean section scar pregnancy which ruptured into the utero-vesical pouch causing hemoperitoneum is presented with very illustrative images. Literature regarding importance of early diagnosis of caesarean scar pregnancy is reviewed.

Research paper thumbnail of Caesarean delivery on maternal request: need to redefine in view of intrapartum cases

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Background: The objective of the study was to analyse the data of caesarean section on maternal r... more Background: The objective of the study was to analyse the data of caesarean section on maternal request (CDMR) both before labour and intrapartum, in low-income society from a town in India.Methods: It was a retrospective observational study of 9331 caesarean section (CS) cases carried out in different small private maternity hospitals over a period of 20 years. We used the data for auditing the CS cases done on maternal request.Results: Out of 9331 CS cases documented, 216 CS were done on maternal request. The incidence of CDMR was 2.31%. About one third cases were intra-partum. The rising trend of CDMR was observed both before labour and intra-partum.Conclusions: There was a need to redefine CDMR in the view of rise in the incidence of women requesting for CS not only before labour but during lab or also. CDMR is no more confined to highly educated, rich and women from urban area. Less educated, low income group women residing in rural area are also becoming aware that CS can be d...

Research paper thumbnail of Learning internal iliac artery ligation and pelvic ureter course through cadaveric dissections

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018

Background: Few surgical procedures, although vital, are not learnt and mastered during postgradu... more Background: Few surgical procedures, although vital, are not learnt and mastered during postgraduate courses in Obstetrics and Gynecology. Internal iliac artery ligation and tracing course of ureter are few of such surgical procedures. Cadaveric dissection sessions organized during postgraduate courses and as CME sessions (continued medical education) have proved useful in learning such unlearnt procedures. This article shares experiences from teaching internal iliac artery ligation, pelvic ureter course tracing and principles of many other unusual gynaecological surgical procedures to Obstetrics and Gynecology specialists and postgraduate students through CME programs involving cadaveric dissection.Methods: This involved organizing and conducting four cadaveric dissection CME workshops at three different teaching institutions. The components of these CMEs were lectures with power point presentations and two-way audio-visual interactive sessions while pelvic anatomy was demonstrated...

Research paper thumbnail of Urethral prolapse- case report and photographs

International journal of reproduction, contraception, obstetrics and gynecology, 2021

This patient a postmenopausal woman 62 years age presented with bleeding per vaginum and burning ... more This patient a postmenopausal woman 62 years age presented with bleeding per vaginum and burning sensation in perineal region. Local (vulva) examination instantly revealed the cause. Spot diagnosis of urethral prolapse was kept (Figure 1). Other than this finding of urethral prolapse; vulva, vestibule, vagina, and cervix were normal except for the atrophic changes of menopause. Blood investigations were within normal limit. Ultrasonography revealed no abnormality in abdomen and pelvis, Pap smear of cervix was suggestive of inflammatory changes. The lesion was surgically excised by modified Kelly-Burnham technique. The modified Kelly-Burnham technique involves excising the prolapsed mucosa over an indwelling bladder catheter and closing the incision by approximating the normal mucosa to the vestibular mucosa with 3-0 polyglycolic acid interrupted absorbable sutures. The excised tissue was sent for histopathology, which revealed chronic nonspecific inflammatory lesion.

Research paper thumbnail of Classification of Cesarean Sections in Small Private Maternity Hospitals as assessed by the Modified Robson Criteria (Canada)

Journal of SAFOG

Aims: To assess 15 years' cesarean section data from small private maternity hospitals by the Mod... more Aims: To assess 15 years' cesarean section data from small private maternity hospitals by the Modified Robson Criteria (Canada). To identify the groups that need to be focused to reduce the cesarean section rate. Materials and methods: Classification of 7,342 cesarean section cases carried out over a period of 15 years from different small private maternity hospitals run by a single obstetrician was done using the Modified Robson Criteria (Canada). The contribution made by each group and subgroup was studied. Results: About 50% of cesarean section cases occur in groups 1 and 2. The second largest group was group 5 (28.61%). A little over three-fourth of the contribution (78.12%) was made by nulliparous and previous cesarean section cases done at term with cephalic presentation. About one-tenth of the total cases belonged to the group of multiparous women. Conclusion: The Modified Robson Criteria give us more clarity and allow perfect targeting. It is necessary to target group 1, 2B, and 5C to bring down the cesarean section rate in private maternity hospitals as the total of these subgroups makes it to little over 60%.

Research paper thumbnail of Audit of Caesarean Section Births in Small Private Maternity Homes: Analysis of 15-Year Data Applying the Modified Robson Criteria, Canada

The Journal of Obstetrics and Gynecology of India, 2016

Research paper thumbnail of Youssef syndrome- manifesting as cyclical hematuria during non-pregnant state and as antepartum hemorrhage during pregnant state

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2015

A woman developed an utero-vesical fistula following her second cesarean section. Between pregnan... more A woman developed an utero-vesical fistula following her second cesarean section. Between pregnancies she manifested cyclical menouria without urinary incontinence. In her third pregnancy for first 3 months her cyclical menouria was relieved as a feature of pregnancy amenorrhea, but it recurred in fourth month of pregnancy as antepartum hemorrhage because of placental location in the fistula area.

Research paper thumbnail of Audit of Third Trimester Pregnancy Admissions for Incidence and Severity of Anemia International Journal of Recent Trends in Science A nd Technology, ISSN 2277-2812 E-ISSN 2249-8109, Vol ume 10, Issue 1, 2014 pp 148-149

Objectives: To know the incidence of anemia in admitted women of third trimester pregnancy. Metho... more Objectives: To know the incidence of anemia in admitted women of third trimester pregnancy. Methods: We prospectively analyzed the Hemoglobin status of pre gnant women, in their third trimester, hospitalized for labour a t MIMSR Medical College and YC rural hospital, Latur. Estimation of hemoglobin of pregnant women was done by automated cell counter. Results: Total 230 antenatal cases were included in study. O f which, 54 women were found to be anemic (<10gm%). Incidence o f anemia (Hb < 10 gm%) is 23.48%. Incidence of severe anemia (Hb < 6 gm%) is 4.34%, moderate anemia (Hb 6-7.9 gm%) is 3. 91% and mild anemia (Hb 8 - 10 gm%) is 19.13%. Conclusion: The incidence of anemia in pregnant women from this hos pital admission is just 23.48%, which is quite lower than other Indian reports.

Research paper thumbnail of Impact of Blood Donation Awareness Campaign by National Service Scheme of Government Medical College, Nanded

Research paper thumbnail of Termination of midtrimester pregnancies with extraovular 0.1% ethacridine lactate. Accurate method for estimation of blood loss. Role of spartein sulfate

Asia-Oceania journal of obstetrics and gynaecology / AOFOG, 1984

... Role of Spartein Sulfate Ravi M. Laul, MD Arun R. Mahale, MBBS and Prabha R. Bhattacharya, MD... more ... Role of Spartein Sulfate Ravi M. Laul, MD Arun R. Mahale, MBBS and Prabha R. Bhattacharya, MD Department of Obstetrics and Gynaecology, Government Medical College, Nagpur. ... The ad-References Bharti P, Vora S. J Obst Gyn India 198 1 ; 3 1 : 38 1 Ingemanson CA. ...

Research paper thumbnail of How much antibiotic for cesarean section and hysterectomy: short course versus long course

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2014

Background: Objective of current study was to compare cost and efficacy of short course and long ... more Background: Objective of current study was to compare cost and efficacy of short course and long course prophylactic antibiotics for hysterectomy and cesarean section. Methods: The current study is observational study. It has two antibiotic regimens a short course and a long course and these are compared for average duration of antibiotics, average cost of antibiotics, and outcome measures such as wound infection and febrile illness. Data were analyzed using t test, Chi-squared test, Epi info software used for analysis. Results: The short course low cost regimen is as effective as more expensive long course regimen, with no significant difference of wound infections and febrile morbidity (P >0.05). Conclusions: No statistical difference as regard wound infection and febrile morbidity in short course and long course of prophylactic antibiotic therapy in cesarean section and hysterectomy. There is statistical difference in antibiotic cost between two regimen, short course and long course for cesarean section and hysterectomy. The cost of antibiotic is 5.53 times less in short course regimen for cesarean section and hysterectomy when compared with long course regimen.

Research paper thumbnail of Foley's Catheter for Cervical Ripening

Journal of Obstetrics and Gynaecology Research, 1999

Research paper thumbnail of Absence of Hypertension: A Bad Prognostic Sign in Placental Abruption

Journal of Obstetrics and Gynaecology Research, 1999

Research paper thumbnail of Absence of Hypertension: A Bad Prognostic Sign in Placental Abruption

Journal of Obstetrics and Gynaecology Research - J OBSTET GYNAECOL RES, 1999

Research paper thumbnail of New schedule of intramuscular iron administration for pregnant women

Asia-Oceania journal of obstetrics and gynaecology / AOFOG, 1993

Pregnant women between 14 and 20 weeks were randomly recruited in 2 groups, 50 to each. One group... more Pregnant women between 14 and 20 weeks were randomly recruited in 2 groups, 50 to each. One group received iron with folic acid orally, other group was given 5 injections of iron dextran spaced 4 weekly. Mean haemoglobin was same for both the groups at the beginning (p > 0.05). At 36 weeks intramuscular group has shown statistically more haemoglobin rise than oral group (p < 0.001). This new intramuscular schedule is found to be convenient, cheap and acceptable to pregnant women. It also assures at least 5 antenatal checkups to a pregnant woman.

Research paper thumbnail of Manual removal versus spontaneous delivery of the placenta at cesarean section in developing countries: a randomized controlled trial and review of literature

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, Dec 30, 2017

Cesarean section (CS) rates have increased; this is especially concerning in developing countries... more Cesarean section (CS) rates have increased; this is especially concerning in developing countries. The mode of placental delivery contributes to morbidity associated with CS and determines blood loss during CS. We aimed to compare manual removal versus spontaneous delivery of the placenta at CS. In a randomized controlled trial, 574 women admitted for primary or repeat elective CS were randomized into two groups. In group A, the placenta was manually removed, whereas in group B, the placenta was left for spontaneous delivery. Blood loss, operative and postoperative data were recorded. Blood loss was 875.2 ± 524.2 ml in group A versus 731.8 ± 426.7 ml in group B (p = .001), with a significant drop in postoperative HB (p = .015) and HCT (p = .031). In group A, odds ratios for blood loss (>1000 ml), HB drop (> 4g/dl), postpartum hemorrhage and blood transfusion were 2.581, 2.850, 2.614 and 1.665, respectively. However, the total operative time (p = .326), duration of hospital sta...

Research paper thumbnail of Caesarean section scar pregnancy: case report, literature review and illustrative images

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

A case report of exogenic caesarean section scar pregnancy which ruptured into the utero-vesical ... more A case report of exogenic caesarean section scar pregnancy which ruptured into the utero-vesical pouch causing hemoperitoneum is presented with very illustrative images. Literature regarding importance of early diagnosis of caesarean scar pregnancy is reviewed.

Research paper thumbnail of Caesarean delivery on maternal request: need to redefine in view of intrapartum cases

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Background: The objective of the study was to analyse the data of caesarean section on maternal r... more Background: The objective of the study was to analyse the data of caesarean section on maternal request (CDMR) both before labour and intrapartum, in low-income society from a town in India.Methods: It was a retrospective observational study of 9331 caesarean section (CS) cases carried out in different small private maternity hospitals over a period of 20 years. We used the data for auditing the CS cases done on maternal request.Results: Out of 9331 CS cases documented, 216 CS were done on maternal request. The incidence of CDMR was 2.31%. About one third cases were intra-partum. The rising trend of CDMR was observed both before labour and intra-partum.Conclusions: There was a need to redefine CDMR in the view of rise in the incidence of women requesting for CS not only before labour but during lab or also. CDMR is no more confined to highly educated, rich and women from urban area. Less educated, low income group women residing in rural area are also becoming aware that CS can be d...

Research paper thumbnail of Learning internal iliac artery ligation and pelvic ureter course through cadaveric dissections

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018

Background: Few surgical procedures, although vital, are not learnt and mastered during postgradu... more Background: Few surgical procedures, although vital, are not learnt and mastered during postgraduate courses in Obstetrics and Gynecology. Internal iliac artery ligation and tracing course of ureter are few of such surgical procedures. Cadaveric dissection sessions organized during postgraduate courses and as CME sessions (continued medical education) have proved useful in learning such unlearnt procedures. This article shares experiences from teaching internal iliac artery ligation, pelvic ureter course tracing and principles of many other unusual gynaecological surgical procedures to Obstetrics and Gynecology specialists and postgraduate students through CME programs involving cadaveric dissection.Methods: This involved organizing and conducting four cadaveric dissection CME workshops at three different teaching institutions. The components of these CMEs were lectures with power point presentations and two-way audio-visual interactive sessions while pelvic anatomy was demonstrated...

Research paper thumbnail of Urethral prolapse- case report and photographs

International journal of reproduction, contraception, obstetrics and gynecology, 2021

This patient a postmenopausal woman 62 years age presented with bleeding per vaginum and burning ... more This patient a postmenopausal woman 62 years age presented with bleeding per vaginum and burning sensation in perineal region. Local (vulva) examination instantly revealed the cause. Spot diagnosis of urethral prolapse was kept (Figure 1). Other than this finding of urethral prolapse; vulva, vestibule, vagina, and cervix were normal except for the atrophic changes of menopause. Blood investigations were within normal limit. Ultrasonography revealed no abnormality in abdomen and pelvis, Pap smear of cervix was suggestive of inflammatory changes. The lesion was surgically excised by modified Kelly-Burnham technique. The modified Kelly-Burnham technique involves excising the prolapsed mucosa over an indwelling bladder catheter and closing the incision by approximating the normal mucosa to the vestibular mucosa with 3-0 polyglycolic acid interrupted absorbable sutures. The excised tissue was sent for histopathology, which revealed chronic nonspecific inflammatory lesion.

Research paper thumbnail of Classification of Cesarean Sections in Small Private Maternity Hospitals as assessed by the Modified Robson Criteria (Canada)

Journal of SAFOG

Aims: To assess 15 years' cesarean section data from small private maternity hospitals by the Mod... more Aims: To assess 15 years' cesarean section data from small private maternity hospitals by the Modified Robson Criteria (Canada). To identify the groups that need to be focused to reduce the cesarean section rate. Materials and methods: Classification of 7,342 cesarean section cases carried out over a period of 15 years from different small private maternity hospitals run by a single obstetrician was done using the Modified Robson Criteria (Canada). The contribution made by each group and subgroup was studied. Results: About 50% of cesarean section cases occur in groups 1 and 2. The second largest group was group 5 (28.61%). A little over three-fourth of the contribution (78.12%) was made by nulliparous and previous cesarean section cases done at term with cephalic presentation. About one-tenth of the total cases belonged to the group of multiparous women. Conclusion: The Modified Robson Criteria give us more clarity and allow perfect targeting. It is necessary to target group 1, 2B, and 5C to bring down the cesarean section rate in private maternity hospitals as the total of these subgroups makes it to little over 60%.

Research paper thumbnail of Audit of Caesarean Section Births in Small Private Maternity Homes: Analysis of 15-Year Data Applying the Modified Robson Criteria, Canada

The Journal of Obstetrics and Gynecology of India, 2016

Research paper thumbnail of Youssef syndrome- manifesting as cyclical hematuria during non-pregnant state and as antepartum hemorrhage during pregnant state

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2015

A woman developed an utero-vesical fistula following her second cesarean section. Between pregnan... more A woman developed an utero-vesical fistula following her second cesarean section. Between pregnancies she manifested cyclical menouria without urinary incontinence. In her third pregnancy for first 3 months her cyclical menouria was relieved as a feature of pregnancy amenorrhea, but it recurred in fourth month of pregnancy as antepartum hemorrhage because of placental location in the fistula area.

Research paper thumbnail of Audit of Third Trimester Pregnancy Admissions for Incidence and Severity of Anemia International Journal of Recent Trends in Science A nd Technology, ISSN 2277-2812 E-ISSN 2249-8109, Vol ume 10, Issue 1, 2014 pp 148-149

Objectives: To know the incidence of anemia in admitted women of third trimester pregnancy. Metho... more Objectives: To know the incidence of anemia in admitted women of third trimester pregnancy. Methods: We prospectively analyzed the Hemoglobin status of pre gnant women, in their third trimester, hospitalized for labour a t MIMSR Medical College and YC rural hospital, Latur. Estimation of hemoglobin of pregnant women was done by automated cell counter. Results: Total 230 antenatal cases were included in study. O f which, 54 women were found to be anemic (<10gm%). Incidence o f anemia (Hb < 10 gm%) is 23.48%. Incidence of severe anemia (Hb < 6 gm%) is 4.34%, moderate anemia (Hb 6-7.9 gm%) is 3. 91% and mild anemia (Hb 8 - 10 gm%) is 19.13%. Conclusion: The incidence of anemia in pregnant women from this hos pital admission is just 23.48%, which is quite lower than other Indian reports.

Research paper thumbnail of Impact of Blood Donation Awareness Campaign by National Service Scheme of Government Medical College, Nanded

Research paper thumbnail of Termination of midtrimester pregnancies with extraovular 0.1% ethacridine lactate. Accurate method for estimation of blood loss. Role of spartein sulfate

Asia-Oceania journal of obstetrics and gynaecology / AOFOG, 1984

... Role of Spartein Sulfate Ravi M. Laul, MD Arun R. Mahale, MBBS and Prabha R. Bhattacharya, MD... more ... Role of Spartein Sulfate Ravi M. Laul, MD Arun R. Mahale, MBBS and Prabha R. Bhattacharya, MD Department of Obstetrics and Gynaecology, Government Medical College, Nagpur. ... The ad-References Bharti P, Vora S. J Obst Gyn India 198 1 ; 3 1 : 38 1 Ingemanson CA. ...

Research paper thumbnail of How much antibiotic for cesarean section and hysterectomy: short course versus long course

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2014

Background: Objective of current study was to compare cost and efficacy of short course and long ... more Background: Objective of current study was to compare cost and efficacy of short course and long course prophylactic antibiotics for hysterectomy and cesarean section. Methods: The current study is observational study. It has two antibiotic regimens a short course and a long course and these are compared for average duration of antibiotics, average cost of antibiotics, and outcome measures such as wound infection and febrile illness. Data were analyzed using t test, Chi-squared test, Epi info software used for analysis. Results: The short course low cost regimen is as effective as more expensive long course regimen, with no significant difference of wound infections and febrile morbidity (P >0.05). Conclusions: No statistical difference as regard wound infection and febrile morbidity in short course and long course of prophylactic antibiotic therapy in cesarean section and hysterectomy. There is statistical difference in antibiotic cost between two regimen, short course and long course for cesarean section and hysterectomy. The cost of antibiotic is 5.53 times less in short course regimen for cesarean section and hysterectomy when compared with long course regimen.

Research paper thumbnail of Foley's Catheter for Cervical Ripening

Journal of Obstetrics and Gynaecology Research, 1999

Research paper thumbnail of Absence of Hypertension: A Bad Prognostic Sign in Placental Abruption

Journal of Obstetrics and Gynaecology Research, 1999

Research paper thumbnail of Absence of Hypertension: A Bad Prognostic Sign in Placental Abruption

Journal of Obstetrics and Gynaecology Research - J OBSTET GYNAECOL RES, 1999

Research paper thumbnail of New schedule of intramuscular iron administration for pregnant women

Asia-Oceania journal of obstetrics and gynaecology / AOFOG, 1993

Pregnant women between 14 and 20 weeks were randomly recruited in 2 groups, 50 to each. One group... more Pregnant women between 14 and 20 weeks were randomly recruited in 2 groups, 50 to each. One group received iron with folic acid orally, other group was given 5 injections of iron dextran spaced 4 weekly. Mean haemoglobin was same for both the groups at the beginning (p > 0.05). At 36 weeks intramuscular group has shown statistically more haemoglobin rise than oral group (p < 0.001). This new intramuscular schedule is found to be convenient, cheap and acceptable to pregnant women. It also assures at least 5 antenatal checkups to a pregnant woman.