Laxmi Vinayaka - Academia.edu (original) (raw)
Papers by Laxmi Vinayaka
Journal of gynecology and womens health, Nov 21, 2018
Hypertensive disorders are the most common medical disorders in pregnancy with incidence independ... more Hypertensive disorders are the most common medical disorders in pregnancy with incidence independent of environmental and ethnic influences. Fetal and maternal morbidity including progressing to eclampsia varies from country to country. Early recognition, diagnosis remains the main the step in management. Eclampsia without typical signs and symptoms of prodrome is called unheraded eclampsia. Maternal and perinatal morbidity and mortality depend upon the number, type and recurrence of seizures in eclampsia, hence definitely high in developing countries and low in developed nations.
Journal of Nepal Medical Association, Apr 1, 2009
Achondrogenesis is a lethal congenital chondrodystrophy characterized by extreme micromelia, smal... more Achondrogenesis is a lethal congenital chondrodystrophy characterized by extreme micromelia, small thorax and polyhydramnios. We describe a case of achondrogenesis type II (Langer-Saldino achondrogenesis). Prenatal ultrasonography at 22-weeks gestation revealed a fetus with large head, short neck and chest, prominent abdomen and short limbs. Pregnancy was terminated. Radiologic examination of neonate revealed features of achondrogenesis type II. Routine ultrasound screening made early detection and timely management possible.
International journal of infertility and fetal medicine, 2018
Introduction: Abnormal uterine bleeding (AUB) in perimenopausal women requires careful evaluation... more Introduction: Abnormal uterine bleeding (AUB) in perimenopausal women requires careful evaluation due to the risk of endometrial malignancy. Symptomatic women with thick endometrium by transvaginal ultrasound (TVS) warrant endometrial sampling. D&C has been the mainstay over decades whereas pipelle has gained popularity due to good tissue yield and easy technique with no admission or anesthesia. This study aims to determine the use of office endometrial biopsy in perimenopausal women with AUB and the endometrial pathology detected by TVS. Materials and methods: In this observational study over five years, 159 women with AUB who underwent endometrial sampling were included. The patients were randomly assigned D&C or pipelle depending on symptoms and endometrial thickness after clinical examination and laboratory investigations. 79.2% of women underwent office endometrial sampling, and 20.8% underwent D&C. samples were sent for histopathology. Statistical analysis was done with respect to the type of sampling and endometrial thickness by TVS. Results: Mean age of the study group was 44 years. About 60.3% of these women had ET of 10-20 mm. It was noted that women with thinner endometrium had more benign lesions and no atypia or malignancy. Sampling was 100% adequate in D&C cases compared to 97.8% of office biopsy group, though statistically not significant. Office endometrial biopsy and D&C yielded adequate sample and a reliable histopathological report and were comparable with respect to sampling, reports and endometrial thickness. Endometrial malignancy was diagnosed in 1.3% of the study group. 56.6% of women had simple hyperplasia without atypia, and 27% had a normal endometrium. Conclusion: Office endometrial biopsy is a sensitive method to detect abnormal endometrium in women with AUB. Diagnostic Office endometrial sampling is comparable to D&C with lesser complications. TVS prior to endometrial sampling improves the sensitivity to diagnose endometrial pathology.
Frontiers in women's health, 2016
Journal of Womens Health, Issues and Care, 2015
Migrated Asymptomatic Intrauterine Contraceptive Device Presenting as Foreign Body Granuloma in A... more Migrated Asymptomatic Intrauterine Contraceptive Device Presenting as Foreign Body Granuloma in Abdominal Cavity: Case Report with Review of Literature Intrauterine contraceptive device is a well-accepted contraception worldwide. Perforation and migration is a serious complication amongst IUCD users. We present a 27 year old para 2 with previous normal delivery. She had IUCD after first child. She consulted doctor for missing device and was told to have a probable expulsion after workup. She came to us for laparoscopic sterilization. IUCD was found as foreign body granuloma in the abdomen at anterior abdominal wall which was laparoscopically retrieved.
Hydrops fetalis is accumulation of extracellular fluid in fetal body cavities: pleural, pericardi... more Hydrops fetalis is accumulation of extracellular fluid in fetal body cavities: pleural, pericardial, scalp and body wall edema and ascites. Non immune hydrops is universal edema unassociated with erythroblastosis. Ultrasound is the diagnostic tool. Various structural abnormalities in the fetus may subsequently lead to hydrops and hence require follow up scan in all cases. Hydrops is due to several factors leading to accumulation of edema. Structural and rhythm cardiac abnormalities are the most common cause followed by chromosomal abnormalities. Fetal anemia is rare but one of the few which can be treated. Anemia is detected by Doppler of middle cerebral artery. Hereditary inborn errors of metabolism cause recurrent hydrops and has poor prognosis. Few management options are available and discussed.
Journal of pediatric genetics, 2012
Urorectal septum malformation sequence is a sporadic malformation due to failure of septation of ... more Urorectal septum malformation sequence is a sporadic malformation due to failure of septation of primitive cloaca with no anal opening. Umbilical cyst can be associated with chromosomal aneuploidy such as trisomy 18 or trisomy 13. We report on a fetus with complete urorectal septum malformation sequence with an umbilical cyst resulting from a patent urachus and with meconium as its content. This report adds to the variety of the causes of umbilical cyst and the spectrum of consequences of urorectal septal defect.
World Journal of Medical and Surgical Case Reports, Jul 26, 2013
50 www.npplweb.com/wjmscr/content/2/12 Address for Correspondence and reprint request to: Dr Sree... more 50 www.npplweb.com/wjmscr/content/2/12 Address for Correspondence and reprint request to: Dr Sreelakshmi KN, Associate Professor,Dept of Obstretics and Gynaecology, Kasturba Medical College, Manipal 576104, India Email: laxmivinayaka@gmail.com ©2013 Sreelakshmi KN et al., Licensee Narain Publishers Pvt. Ltd. (NPPL) Submitted: March 25, 2013; Accepted: May 23, 2013; Published: July 26, 2013 Case Report Open Access
The Journal of Maternal-Fetal & Neonatal Medicine, 2015
We aimed to determine the value of autopsy in fetuses with antenatally diagnosed oligohydramnios.... more We aimed to determine the value of autopsy in fetuses with antenatally diagnosed oligohydramnios. We evaluated all fetal losses over a period of 6.5 years. Those with oligohydramnios on antenatal scan were critically analyzed. Oligohydramnios was defined as amniotic fluid index of less than five objectively or as an obvious lack of liquor at subjective assessment. A detailed postmortem examination was carried out in all the fetuses after obtaining an informed consent. Fetal autopsy was conducted in 255 cases. Fifty-five (21.5%) fetuses were diagnosed to have oligohydramnios on antenatal ultrasonography. On analysis of antenatal causes of oligohydramnios, maternal/placental factors were noted in 18%, ultrasound findings known to affect amniotic fluid in 27% while cause remained unidentified in 54.5% of cases. On autopsy, fetal malformations were noted in 61.8% cases, intrauterine growth retardation in 21.8% fetuses and no obvious malformations in 16.3% fetuses. Renal anomalies were noted in 40% cases and non-renal malformations in 21.8% cases. The postmortem examination helped us to identify the cause of fetal loss in 46 (83.6%) fetuses with antenatal oligohydramnios. A working diagnosis could not have been established without autopsy in 19 (34.5%) cases.
Case Reports in Obstetrics and Gynecology, 2012
Chorioangioma is a benign angioma of placenta arising from chorionic tissue. Large chorioangioma ... more Chorioangioma is a benign angioma of placenta arising from chorionic tissue. Large chorioangioma has unfavourable effects on both mother and fetus. We describe a case with large chorioangioma that had a poor outcome on the fetus. We also reviewed the literature on prognostic factors affecting fetal outcome.
Case reports in obstetrics and gynecology, 2011
Hepatic mesenchymal hamartoma is a rare benign tumor. We present an unusual case of a fetal abdom... more Hepatic mesenchymal hamartoma is a rare benign tumor. We present an unusual case of a fetal abdominal cyst, later diagnosed histopathologically to be mesenchymal hamartoma of liver. The organ of origin was indeterminate on both prenatal and postnatal ultrasounds. As there are no specific sonological findings, whenever a large multicystic fetal abdominal cyst is seen, mesenchymal hamartoma should be considered as a possibility.
Journal of Human Reproductive Sciences, 2011
Extrapelvic endometriosis is an uncommon g y n e c o l o g i c a l p r o b l e m. U m b i l i c a... more Extrapelvic endometriosis is an uncommon g y n e c o l o g i c a l p r o b l e m. U m b i l i c a l endometriosis at the site of the laparoscopic entry is one of the common sites. Villar in 1886 reported the first case of umbilical endometriosis. Hence, this condition is also called Villar's nodule. [4] Surgical scar endometriosis is one of the sites. In our case, possibly the previous laparoscopic port site
Journal of Human Reproductive Sciences, 2011
Journal of gynecology and womens health, Nov 21, 2018
Hypertensive disorders are the most common medical disorders in pregnancy with incidence independ... more Hypertensive disorders are the most common medical disorders in pregnancy with incidence independent of environmental and ethnic influences. Fetal and maternal morbidity including progressing to eclampsia varies from country to country. Early recognition, diagnosis remains the main the step in management. Eclampsia without typical signs and symptoms of prodrome is called unheraded eclampsia. Maternal and perinatal morbidity and mortality depend upon the number, type and recurrence of seizures in eclampsia, hence definitely high in developing countries and low in developed nations.
Journal of Nepal Medical Association, Apr 1, 2009
Achondrogenesis is a lethal congenital chondrodystrophy characterized by extreme micromelia, smal... more Achondrogenesis is a lethal congenital chondrodystrophy characterized by extreme micromelia, small thorax and polyhydramnios. We describe a case of achondrogenesis type II (Langer-Saldino achondrogenesis). Prenatal ultrasonography at 22-weeks gestation revealed a fetus with large head, short neck and chest, prominent abdomen and short limbs. Pregnancy was terminated. Radiologic examination of neonate revealed features of achondrogenesis type II. Routine ultrasound screening made early detection and timely management possible.
International journal of infertility and fetal medicine, 2018
Introduction: Abnormal uterine bleeding (AUB) in perimenopausal women requires careful evaluation... more Introduction: Abnormal uterine bleeding (AUB) in perimenopausal women requires careful evaluation due to the risk of endometrial malignancy. Symptomatic women with thick endometrium by transvaginal ultrasound (TVS) warrant endometrial sampling. D&C has been the mainstay over decades whereas pipelle has gained popularity due to good tissue yield and easy technique with no admission or anesthesia. This study aims to determine the use of office endometrial biopsy in perimenopausal women with AUB and the endometrial pathology detected by TVS. Materials and methods: In this observational study over five years, 159 women with AUB who underwent endometrial sampling were included. The patients were randomly assigned D&C or pipelle depending on symptoms and endometrial thickness after clinical examination and laboratory investigations. 79.2% of women underwent office endometrial sampling, and 20.8% underwent D&C. samples were sent for histopathology. Statistical analysis was done with respect to the type of sampling and endometrial thickness by TVS. Results: Mean age of the study group was 44 years. About 60.3% of these women had ET of 10-20 mm. It was noted that women with thinner endometrium had more benign lesions and no atypia or malignancy. Sampling was 100% adequate in D&C cases compared to 97.8% of office biopsy group, though statistically not significant. Office endometrial biopsy and D&C yielded adequate sample and a reliable histopathological report and were comparable with respect to sampling, reports and endometrial thickness. Endometrial malignancy was diagnosed in 1.3% of the study group. 56.6% of women had simple hyperplasia without atypia, and 27% had a normal endometrium. Conclusion: Office endometrial biopsy is a sensitive method to detect abnormal endometrium in women with AUB. Diagnostic Office endometrial sampling is comparable to D&C with lesser complications. TVS prior to endometrial sampling improves the sensitivity to diagnose endometrial pathology.
Frontiers in women's health, 2016
Journal of Womens Health, Issues and Care, 2015
Migrated Asymptomatic Intrauterine Contraceptive Device Presenting as Foreign Body Granuloma in A... more Migrated Asymptomatic Intrauterine Contraceptive Device Presenting as Foreign Body Granuloma in Abdominal Cavity: Case Report with Review of Literature Intrauterine contraceptive device is a well-accepted contraception worldwide. Perforation and migration is a serious complication amongst IUCD users. We present a 27 year old para 2 with previous normal delivery. She had IUCD after first child. She consulted doctor for missing device and was told to have a probable expulsion after workup. She came to us for laparoscopic sterilization. IUCD was found as foreign body granuloma in the abdomen at anterior abdominal wall which was laparoscopically retrieved.
Hydrops fetalis is accumulation of extracellular fluid in fetal body cavities: pleural, pericardi... more Hydrops fetalis is accumulation of extracellular fluid in fetal body cavities: pleural, pericardial, scalp and body wall edema and ascites. Non immune hydrops is universal edema unassociated with erythroblastosis. Ultrasound is the diagnostic tool. Various structural abnormalities in the fetus may subsequently lead to hydrops and hence require follow up scan in all cases. Hydrops is due to several factors leading to accumulation of edema. Structural and rhythm cardiac abnormalities are the most common cause followed by chromosomal abnormalities. Fetal anemia is rare but one of the few which can be treated. Anemia is detected by Doppler of middle cerebral artery. Hereditary inborn errors of metabolism cause recurrent hydrops and has poor prognosis. Few management options are available and discussed.
Journal of pediatric genetics, 2012
Urorectal septum malformation sequence is a sporadic malformation due to failure of septation of ... more Urorectal septum malformation sequence is a sporadic malformation due to failure of septation of primitive cloaca with no anal opening. Umbilical cyst can be associated with chromosomal aneuploidy such as trisomy 18 or trisomy 13. We report on a fetus with complete urorectal septum malformation sequence with an umbilical cyst resulting from a patent urachus and with meconium as its content. This report adds to the variety of the causes of umbilical cyst and the spectrum of consequences of urorectal septal defect.
World Journal of Medical and Surgical Case Reports, Jul 26, 2013
50 www.npplweb.com/wjmscr/content/2/12 Address for Correspondence and reprint request to: Dr Sree... more 50 www.npplweb.com/wjmscr/content/2/12 Address for Correspondence and reprint request to: Dr Sreelakshmi KN, Associate Professor,Dept of Obstretics and Gynaecology, Kasturba Medical College, Manipal 576104, India Email: laxmivinayaka@gmail.com ©2013 Sreelakshmi KN et al., Licensee Narain Publishers Pvt. Ltd. (NPPL) Submitted: March 25, 2013; Accepted: May 23, 2013; Published: July 26, 2013 Case Report Open Access
The Journal of Maternal-Fetal & Neonatal Medicine, 2015
We aimed to determine the value of autopsy in fetuses with antenatally diagnosed oligohydramnios.... more We aimed to determine the value of autopsy in fetuses with antenatally diagnosed oligohydramnios. We evaluated all fetal losses over a period of 6.5 years. Those with oligohydramnios on antenatal scan were critically analyzed. Oligohydramnios was defined as amniotic fluid index of less than five objectively or as an obvious lack of liquor at subjective assessment. A detailed postmortem examination was carried out in all the fetuses after obtaining an informed consent. Fetal autopsy was conducted in 255 cases. Fifty-five (21.5%) fetuses were diagnosed to have oligohydramnios on antenatal ultrasonography. On analysis of antenatal causes of oligohydramnios, maternal/placental factors were noted in 18%, ultrasound findings known to affect amniotic fluid in 27% while cause remained unidentified in 54.5% of cases. On autopsy, fetal malformations were noted in 61.8% cases, intrauterine growth retardation in 21.8% fetuses and no obvious malformations in 16.3% fetuses. Renal anomalies were noted in 40% cases and non-renal malformations in 21.8% cases. The postmortem examination helped us to identify the cause of fetal loss in 46 (83.6%) fetuses with antenatal oligohydramnios. A working diagnosis could not have been established without autopsy in 19 (34.5%) cases.
Case Reports in Obstetrics and Gynecology, 2012
Chorioangioma is a benign angioma of placenta arising from chorionic tissue. Large chorioangioma ... more Chorioangioma is a benign angioma of placenta arising from chorionic tissue. Large chorioangioma has unfavourable effects on both mother and fetus. We describe a case with large chorioangioma that had a poor outcome on the fetus. We also reviewed the literature on prognostic factors affecting fetal outcome.
Case reports in obstetrics and gynecology, 2011
Hepatic mesenchymal hamartoma is a rare benign tumor. We present an unusual case of a fetal abdom... more Hepatic mesenchymal hamartoma is a rare benign tumor. We present an unusual case of a fetal abdominal cyst, later diagnosed histopathologically to be mesenchymal hamartoma of liver. The organ of origin was indeterminate on both prenatal and postnatal ultrasounds. As there are no specific sonological findings, whenever a large multicystic fetal abdominal cyst is seen, mesenchymal hamartoma should be considered as a possibility.
Journal of Human Reproductive Sciences, 2011
Extrapelvic endometriosis is an uncommon g y n e c o l o g i c a l p r o b l e m. U m b i l i c a... more Extrapelvic endometriosis is an uncommon g y n e c o l o g i c a l p r o b l e m. U m b i l i c a l endometriosis at the site of the laparoscopic entry is one of the common sites. Villar in 1886 reported the first case of umbilical endometriosis. Hence, this condition is also called Villar's nodule. [4] Surgical scar endometriosis is one of the sites. In our case, possibly the previous laparoscopic port site
Journal of Human Reproductive Sciences, 2011