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Papers by Sachchidananda Maiti

JOGC/Journal of obstetrics and gynaecology Canada, May 1, 2024

INTAS POLIVET, 2014

A five year old Pomeranian bitch was presented with signs of severe panting, restlessness, muscle... more A five year old Pomeranian bitch was presented with signs of severe panting, restlessness, muscle fasciculation, hyperthermia and hypotension. History revealed the bitch whelped 4 days back. The bitch was diagnosed to be suffering from pregnancy eclampsia confirmed by low serum calcium levels. Treatment with intravenous calcium gluconate 10% solution proved to be effective.

Journal of Obstetrics and Gynaecology, 2002

The Internet Journal of Gynecology and Obstetrics, 2003

First described by Noonan and Ehmke (1963), Noonan Syndrome is an Autosomal Dominant condition wi... more First described by Noonan and Ehmke (1963), Noonan Syndrome is an Autosomal Dominant condition with variable expression. It is associated with short stature, short neck with webbing (phenotypically like Turner Syndrome), cardiac anomalies particularly dysplastic pulmonary valve with Pulmonary stenosis(50%), atrial septal defect(10%), ventricular septal defect, patent ductus arteriosus, hypertrophic cardiomyopathy, a characteristic chest deformity with pectus excavatum inferiorly and pectus carinatum superiorly(70%), widespread nipple and hypertelorism. The chromosomes are normal. We report a case of a 29 yr old primigravida with Noonan Syndrome sought preconceptional counselling and conceived within 6 months. Throughout the antenatal period , she was followed up closely by a team comprising of Obstetrician, Cardiologist, Ultrasonologist and her General Practitioner.

Journal of Obstetrics & Gynaecology, 2009

of epidural analgesia with 0.5% lignocaine and 75 mg of fentanyl did not provide adequate analges... more of epidural analgesia with 0.5% lignocaine and 75 mg of fentanyl did not provide adequate analgesia she was given a spinal anaesthetic for the repair. On the first postnatal day, her urine output was 900 ml in 24 h. Her blood pressure was elevated at 150/90 mmHg with no evidence of proteinuria. Blood investigations revealed an elevated creatinine at 163 mmol/l (normal 60–120 mmol/l). Coagulation studies and liver function tests were normal. A renal scan revealed bilateral mild hydronephrosis. She was reviewed by a urologist who advised conservative management and avoidance of NSAIDs. Her renal function returned to normal on the 3rd postnatal day and she was discharged from hospital in good condition on the 5th postnatal day. At her 6-week postnatal visit, she was well with no detectable problems.

Archives of Disease in Childhood - Fetal and Neonatal Edition, 2011

ObjectiveTo compare the pregnancy outcomes of women with morbid obesity (body mass index (BMI) ≥4... more ObjectiveTo compare the pregnancy outcomes of women with morbid obesity (body mass index (BMI) ≥40) and extremely underweight (BMI<16) with that of women with normal BMI (18.5 to 24.99)Designretrospective observational study over 3 years.SettingPenine Acute Hospitals NHS trust.ResultsThe total number of deliveries during this period was 33 509.The number of women pregnant with normal BMI were 15 275(46%). There were 580 women (2%) with morbid obesity and 40 women (0.1%) were extremely underweight during the same period. Only 11% of obese women took folic acid prepregnancy. Only 1% of women in the normal BMI category had gestational diabetes whereas 9% of morbidly obese women had gestational diabetes. The rates of induction (28%) and caesarean section (42%) were higher in the high BMI group. 4% of the babies were macrosomic (birth weight≥4.5 kg) in the high BMI group and 1% in the normal BMI group. The incidence of shoulder dystocia was 2% in high BMI category and 1% in the normal BMI group. 25% of babies in the low BMI group had a birth weight of less than 2.5 kg. This was 8% in the normal and 4% in the high BMI categories.ConclusionsThe importance of pre pregnancy counselling and weight reduction cannot be over emphasised. Efforts should be directed in extremely underweight women to attain adequate pre pregnancy weight. Further research is needed to determine the optimal weight gain/reduction during pregnancy for women in different BMI categories.

BMJ case reports, 2013

Simultaneous bilateral adnexal torsion is very rare especially in adults. There have been few cas... more Simultaneous bilateral adnexal torsion is very rare especially in adults. There have been few cases reported in children with only one previous case reported in adults since 1984, which was complicated by entanglement of both adnexae. In adults, the use of ovarian stimulation for treatment of infertility can increase the risk of ovarian torsion. We report the second case of simultaneous bilateral adnexal torsion in an adult female without follicular stimulation.

Post-menopausal bleeding (PMB) is usually caused by several endometrial conditions (hyperplasia a... more Post-menopausal bleeding (PMB) is usually caused by several endometrial conditions (hyperplasia and carcinoma) for which there are evidence-based treatments. However, there is little literature and no evidence-based treatments for a finding of proliferative endometrium without atypia on Pipelle endometrial biopsy in women presenting with PMB. Our aim is to explore management and treatment options for this subset of women. This is a retrospective, observational case series review of women presenting with PMB to a gynaecology rapid access clinic at a District General Hospital in Manchester, UK over a period of three weeks. Four women who were found to have a proliferative or secretory endometrium on endometrial Pipelle biopsy were chosen. Their history, examination findings, investigations, treatment and follow-up findings were then analysed. This case series has identified the management dilemma posed by patients with proliferative endometrium with no atypia on endometrial sampling. The four patients were followed-up with a repeat Pipelle endometrial biopsy six weeks after presentation to the specialist gynaecology unit. They were subsequently counselled or treated with oral progesterone therapy for six to eight weeks. The management options included the Mirena intrauterine system (IUS), oral progesterone therapy and discharging the patient back to primary care. There is no consensus on the importance of oral progesterone or the duration of follow up necessary to monitor for the development of endometrial hyperplasia or cancer in this subset of patients. Further research is needed to develop evidence-based, management guidelines for proliferative endometrium in women with PMB.

Headache is a common symptom in pregnancy, reported in up to 35% of women during their antenatal ... more Headache is a common symptom in pregnancy, reported in up to 35% of women during their antenatal period. During pregnancy, women may experience their first episodes of headache, which could become a recurrent problem. The purpose of this review is to recognise the classical presentation and contributory factors of primary and secondary headaches. Primary headaches include tension type headache and migraine. Secondary headaches include hypertension, pre-eclampsia, idiopathic intracranial hypertension, subarachnoid haemorrhage, cerebral venous thrombosis, and reversible cerebral vasoconstriction syndrome. As we encounter headaches so frequently in patients who are pregnant, we need to equip ourselves to recognise the ‘red flag’ signs that would alert practitioners to the need for urgent management and differentiate it from those that are benign. This article will cover the following topics: • Primary Headaches − Tension Type Headache − Migraine • Secondary Headaches − Hypertension/Pre...

BMJ case reports, 2012

Caesarean scar pregnancy is a rare type of ectopic pregnancy. The authors present a 24-year-old w... more Caesarean scar pregnancy is a rare type of ectopic pregnancy. The authors present a 24-year-old woman 5 weeks after her last menstrual period. She had a history of a single caesarean section which was followed by a normal vaginal delivery. Ultrasound imaging revealed a pregnancy in her lower segment caesarean section scar. The decision on the choice of treatment was influenced mainly by the β-human chorionic gonadotropin levels in the patient's blood. Although a few reports have been published on similar cases, spontaneous resolution of a caesarean scar ectopic pregnancy of less than 5 weeks gestation is yet to be reported. The patient is now asymptomatic and her urine pregnancy test has been confirmed negative.

Cases Journal, 2009

Leiomyomas are benign tumours commonly occurring in the uterine wall. They are rarely seen in the... more Leiomyomas are benign tumours commonly occurring in the uterine wall. They are rarely seen in the vaginal wall leading to pressure symptoms on urinary tract. Indentation of leiomyoma from anterior vaginal wall into the bladder is rare and hence we report one such case. A 55 year old Caucasian woman presented to urology clinic with recurrent Urinary tract infection and pressure symptoms. After the diagnosis of a vaginal mass, she was referred to Gynaecology clinic. During the excision of the vaginal mass its indentation into the bladder was noted. Histology report confirmed the diagnosis of benign leiomyoma.

Journal of Medical Case …, 2008

Introduction: This case illustrates the unusual complication of granulomatous peritonitis followi... more Introduction: This case illustrates the unusual complication of granulomatous peritonitis following rupture of a dermoid cyst in pregnancy resembling disseminated ovarian carcinoma. To the best of the authors' knowledge, this is the first report of this complication during advanced pregnancy in the literature. Case presentation: A dermoid cyst ruptured during surgical removal in the second trimester of pregnancy in a 27-year-old primigravida. Postoperatively the patient suffered pulmonary embolism and leakage of sebaceous material through the abdominal wound. She gradually developed significant abdominal distension, gastrointestinal symptoms and lost more than 8 kg of weight in the 12 weeks postoperatively. The baby was delivered at 31 weeks by a technically challenging caesarean section owing to severe dense adhesions obscuring the uterus. Bowel resection was performed for suspected malignant infiltration and adhesion causing obstruction. She had a protracted convalescence with an ileostomy and mucus fistula. Histology confirmed granulation without malignancy. One year following the surgical treatment, she had recovered well and was planning her next pregnancy. Conclusion: Although granulomatous peritonitis following rupture of a dermoid cyst is very rare, awareness is the key to diagnosis and appropriate management. Per-operative frozen section may be helpful.