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Papers by sukesh kathpalia

Juniper online journal of case studies, Feb 27, 2018

Fibroids uterus also called uterine leiomyoma are the most frequently encountered benign tumours ... more Fibroids uterus also called uterine leiomyoma are the most frequently encountered benign tumours of the uterus. Many fibroids are asymptomatic and are picked up on routine examination. Clinical features depend on number, size and location of the fibroids. Symptomatic fibroids may be managed medically or surgically. Hysterectomy by different routes is the commonest operation performed for fibroid uterus. Hysterectomy may not be the desired where uterus needs to be retained for different reasons. Removal of fibroids called myomectomy followed by reconstruction of uterus is the correct and desired mode of management in such cases. We report one such case where 29 fibroids of varying sizes were removed abdominally and uterus reconstructed in an unmarried girl who conceived spontaneously within one year of surgery after marriage. Vasopressin is effective in reducing the blood loss at the time of myomectomy. Mifepristone is a new mode of treating fibroids medically.

Journal of clinical case studies reviews & reports, Dec 30, 2021

Introduction: At present one of the major challenges our country is facing is population explosio... more Introduction: At present one of the major challenges our country is facing is population explosion, unintended and unwanted pregnancies. This is in spite of being the first country in the world to launch a family planning program. Long-acting, reversible family planning methods, such as intrauterine contraceptive devices, have been reported to be very effective. This is usually inserted as an interval procedure but can be inserted post-delivery also which has many advantages. Study was undertaken to find out the present status of this programme ten years after its initiation by the government. Materials and Methods: This observational study was conducted for three months at three large medical institutes. The participants were all labour cases admitted for delivery. Only willing cases were included; they were interviewed to find out their awareness, acceptance and planning for future contraception. Results and Observations: 3453 were willing to be part of the study. The study showed that a large number of women (23.5%) relied upon breast feeding as a method of spacing. Almost half of them (47.5%) were undecided regarding methods to delay the next pregnancy. 81% had heard about the device. 5.9% had some information regarding insertion after delivery. Only 9.1% cases remembered being told something specifically about insertion after delivery. Insertion was done in 3.5% cases, mostly with cesarean section. Discussion: Contraception is an important part of population control and prevention of unwanted and unintended pregnancies. In India, as in many other countries, postpartum family planning is usually initiated after 6 weeks postpartum. The postpartum period is an optimal time for effective contraception as the new mother is more receptive to accept family planning and the couple is of proven fertility. Though insertion of contraceptive device immediately after delivery is a good method of contraception but its awareness, acceptance and insertion is extremely low hence there is a great need of making concerted efforts to improve its acceptance and insertion. Counseling during antenatal period is the ideal time.

COJ Nursing & Healthcare, 2018

Outflow tract obstruction of female genital tract can lead to varied presentations depending on m... more Outflow tract obstruction of female genital tract can lead to varied presentations depending on many factors. Most of the obstructions are congenital and usually occur in the lower part. A rare case of obstruction of cervical opening is reported. 37 years old lady with two previous cesarean deliveries reported with complaints of lower abdominal pain along with difficulty in passing urine, she was detected to have a lower abdominal lump. Imaging studies suggested retention cyst. Examination under anesthesia showed obliterated external cervical opening. Dilatation resulted in extrusion of large quantity of chocolate material. She made good postoperative recovery but the cause of cervical stenosis was not clear.

Medical Journal Armed Forces India, 2017

Medical Journal Armed Forces India, 2015

Background: In spite of many available contraceptives numerous unwanted and unplanned pregnancies... more Background: In spite of many available contraceptives numerous unwanted and unplanned pregnancies occur. Though the couples desire contraception but are not able to accept it due to their ignorance and misconceptions. Intrauterine Contraceptive Device (IUCD); an effective contraceptive is usually inserted six weeks after delivery. It can be inserted within 48 h of delivery called postpartum insertion for which government has started the program in many states. The study was undertaken to find out the choices about contraception after delivery and awareness about postpartum insertion. Methods: The present observational study was conducted in one of the zonal service hospitals. 500 antenatal cases were included in the study. Their choice of contraception after delivery and awareness was determined through a questionnaire. Reasons for refusal of postpartum insertion were recorded. A small sample of staff also was included in the study. Results: 500 cases were included in the study, a large number had decided about contraception; mainly breast feeding supplemented by barrier contraceptive. 94 of 500 were willing for insertion of contraceptive device but not immediately after delivery due to apprehension in general and fear of side effects. Staff's awareness about postpartum insertion was poor. Conclusion: Knowledge and acceptance of postpartum insertion is very low among antenatal women; probably because the concept is new in the community. There is a strong need to increase the knowledge and awareness about this by health education and counseling.

Medical Journal Armed Forces India, 2012

Introduction: The rate of exclusive and early breastfeeding in India is only 64% (NFHS 5-National... more Introduction: The rate of exclusive and early breastfeeding in India is only 64% (NFHS 5-National Family Health Survey) even though WHO has suggested exclusive breastfeeding for 6 months. Breastfeeding plays a crucial role in the development of a newborn, not only physically but mentally as well. Most of the would-be Mothers spend maximum time with their mother or mother-in-law who has the biggest influence on counseling these new-to-be mothers. These grandmothers know the benefits of breastfeeding, the importance of a special diet, and proper hydration for good quality milk but report inadequacies in the treatment of breast complications and the need for exclusive breastfeeding till 6 months of life. Which is why we decided to explore the knowledge, attitude, and practices about exclusive breastfeeding among these grandmothers. Material and methods: A survey was done in Dr. D. Y. Patil Hospital Pimpri, in which 270 grandmothers were interviewed out of 309 deliveries in the hospital over a period of 3 months from July to September 2022. This study was done as a part of World Breastfeeding Week activities. A questionnaire was formed to ask grandmothers about antenatal and postnatal counseling, exclusive breastfeeding, early initiation of breastfeeding, the importance of colostrum, etc. Analysis of the collected data was done using percentages and represented diagrammatically. Results: It was observed that though 70% of grandmothers knew about the early initiation of BF, only 43% of patients actually initiated breastfeeding within one hour. The importance of colostrum is known by only 66% of grandmothers but colostrum feeding was encouraged by 81% of grandmothers. Almost all grandmothers knew about 6-month period of exclusive breastfeeding and it is practiced by most of them. A very minor 19.32% of mothers are counseled antenatally about breastfeeding while 90% of mothers are counseled postnatally by grandmothers. Conclusion: Breastfed babies seem to have better immunity and development than those fed by top feeds. The awareness about this is much less than what it should be. So, it is important to raise the awareness amongst community through the most powerful resources. So, interventions to promote exclusive breastfeeding should be tailored to the needs of each population by identifying the factors that influence the practice in a given context. Grandmothers have knowledge that has been validated by their experiences and can directly affect the new, would-be mothers and their breastfeeding practices. Clinical significance: These results indicate that there is a significant gap between knowledge and practices about exclusive and early breastfeeding and more active steps should be taken to change the attitude of grandmothers so that they will more actively and positively counsel the mothers to breastfeed. It is important to raise the awareness and implications of exclusive breastfeeding. Categories: Obstetrics and gynecology, Breastfeeding, Breastfeeding awareness.

Medical Journal Armed Forces India, 2018

Medical Journal Armed Forces India, 2016

Medical Journal Armed Forces India, 2017

Background: Ectopic pregnancy or extrauterine pregnancy will invariably result in abortion or rup... more Background: Ectopic pregnancy or extrauterine pregnancy will invariably result in abortion or rupture. Though there are risk factors for ectopic pregnancy, but at times the condition can occur without any apparent predisposing factor. Cases admitted with provisional diagnosis of ectopic pregnancy were included in this prospective study. Methods: Eighty suspected cases of ectopic pregnancy were incorporated in the study. The management was done based on standard practice. All the cases underwent urine pregnancy test, routine blood investigations including blood group, and transvaginal ultrasound. Serial bhCG was measured in cases where the diagnosis was not clear initially. Results: Incidence of ectopic was 2.46 per 100 deliveries; there was no apparent risk factor in 28.7% and many cases had more than one risk factor. 'Triad' of ectopic was present in only 21 cases. Sixteen cases were asymptomatic and two were admitted as emergency. Ultrasound findings were inconsistent and wide ranging. In 37 doubtful cases, bhCG was measured serially. There was one case of suspected interstitial pregnancy confirmed on laparoscopy. Twenty-seven cases were managed medically, and 9 were managed expectantly. Fortysix cases were managed surgically either by laparoscopy or by laparotomy. Salpingectomy was performed in 37 cases, and salpingostomy in 7 cases either laparoscopically or by laparotomy. Conclusion: Ectopic pregnancy can be managed by laparotomy, operative laparoscopy, and medically and occasionally by observation alone. Management must be customized to the clinical condition and needs of future fertility of the patient.

EC Gynaecology, Mar 16, 2020

International journal of clinical obstetrics and gynaecology, 2021

Background: Previous studies indicate that new-borns delivered by elective caesarean section are ... more Background: Previous studies indicate that new-borns delivered by elective caesarean section are more prone to respiratory morbidity after birth. Objective: To find out whether the mode of delivery is associated with the neonatal respiratory outcomes. Methods: In this observational study, following three groups of pregnant women (30 in each group) were included a) normal vaginal delivery b) elective LSCS and c) emergency LSCS. Respiratory morbidity (Tachypnoea, chest retraction, grunting, and nasal flaring) and APGAR scores were compared between three groups. Results: Respiratory morbidity was higher in elective and emergency LSCS groups compared to normal vaginal delivery group. However, the differences were not statistically significant. APGAR scores at 1 and 5 minutes were similar in three groups. NICU admissions were higher in elective caesarean groups as compared to the other two groups. Conclusion: Higher incidence of respiratory distress syndrome was noted in babies born to mothers who have undergone elective caesarean section.

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019

Background: Breastmilk is considered as one of the healthiest, nutrition-rich yet least expensive... more Background: Breastmilk is considered as one of the healthiest, nutrition-rich yet least expensive method of infant feeding. It is a universally accepted fact that breastmilk meets all the nutritional demands of the new-born. There are extensive benefits of breastfeeding for the new-born as well as for the nursing mother which have been documented from time to time.Methods: A multiple-choice questionnaire was used to interview the participants during data collection.Results: Using the IBM SPSS version 20 software, descriptive analysis of the categorical variables has been presented using frequency and percentage tables. Regarding the practices about breast feeding in primigravidas, their concepts about the same have been captured in this study.Conclusions: Though the knowledge about exclusive breast feeding was not extraordinary among the participants, they had a very favourable attitude towards the same. Almost all patients were also extremely receptive and inquisitive during the se...

Indian Journal of Obstetrics and Gynecology Research

Congenital anomalies can be due to various reasons. Some of these can significantly affect the vi... more Congenital anomalies can be due to various reasons. Some of these can significantly affect the viability of the fetus, some may impair quality of life subsequent to delivery and some may not have any significant effect. It is necessary to determine presence of congenital anomalies in-utero for better maternal and neonatal outcomes. Objectives: To determine presence of congenital anomalies in mothers visiting antenatal clinics by conducting a second trimester anomaly scan. Materials and Methods: The study evaluated 2000 mothers visiting antenatal care in D. Y Patil Medical College and Hospital in Pune. A second trimester anomaly scan was conducted between 18-20 weeks of gestation in all the patients. Results: The rate of fetal anomalies noted were 0.8% (16/2000 cases). 13 congenital anomalies were incompatible for viability of the fetus and hence were terminated. 3 congenital anomalies were minor in nature and hence continuation of pregnancy was advised. 2 mothers who were unbooked during antenatal period, delivered anomalous babies and were as well included in the evaluation. Conclusion: A second trimester anomaly scan should be made mandatory to identify any malformation in the growing fetus as we still have an option to terminate the pregnancy and save the family from the future setback. Also, with the advent of fetal medicine we can identify and treat the fetus in utero which might reduce the future complications. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Medical Journal Armed Forces India, 2016

Medical Journal Armed Forces India, 2016

Academic Emergency Medicine, 2002

Journal of South Asian Federation of Obstetrics and Gynaecology

Backround: Uterus didelphys with obliterated half-vagina and absent kidney on the same side is a ... more Backround: Uterus didelphys with obliterated half-vagina and absent kidney on the same side is a syndrome with very low incidence known as Herlyn-Werner-Wunderlich syndrome (HWW) and also known as obstructed half-vagina and ipsilateral renal anomaly (OHVIRA). 1,2 Case report: Sixteen-year-old female presented with cyclical pain in abdomen mostly from Day 1 on her periods since menarche since 1-2 years. She had regular menstrual cycle with dysmenorrhea. Clinical examination was done, and on ultrasound, we diagnosed it as HWW syndrome. Intraoperatively, a bulge was arising from right vaginal wall, and on left side, cervix was felt with normal size uterus. Incision was taken on the bulge, about 60cc of mucous discharge was drained. We confirmed uterine didelphys. Later suturing was done on the opening of the right vagina, to keep it patent. Conclusion: We should think of HWW syndrome in patients who have cyclic pain in abdomen and also in newborn cases with any renal abnormalities. Early and prompt surgical therapy prevents further complications. Clinical significance: Early diagnosis and treatment prevents complications such as endometriosis and infertility.

International Journal of Clinical Obstetrics and Gynaecology, 2021

Background: Previous studies indicate that new-borns delivered by elective caesarean section are ... more Background: Previous studies indicate that new-borns delivered by elective caesarean section are more prone to respiratory morbidity after birth. Objective: To find out whether the mode of delivery is associated with the neonatal respiratory outcomes. Methods: In this observational study, following three groups of pregnant women (30 in each group) were included a) normal vaginal delivery b) elective LSCS and c) emergency LSCS. Respiratory morbidity (Tachypnoea, chest retraction, grunting, and nasal flaring) and APGAR scores were compared between three groups. Results: Respiratory morbidity was higher in elective and emergency LSCS groups compared to normal vaginal delivery group. However, the differences were not statistically significant. APGAR scores at 1 and 5 minutes were similar in three groups. NICU admissions were higher in elective caesarean groups as compared to the other two groups. Conclusion: Higher incidence of respiratory distress syndrome was noted in babies born to mothers who have undergone elective caesarean section.

Medical Journal Armed Forces India, 2016

Background: Many women die while going through childbirth; hemorrhage being common cause for mate... more Background: Many women die while going through childbirth; hemorrhage being common cause for maternal mortality. Many maternal deaths can be saved by building up hemoglobin antenatally and timely blood transfusion. The transfusion may result in many complications hence the blood transfusion practices should be streamlined and adhered to and reviewed periodically. This retrospective study was undertaken at one of the tertiary care hospital to find out the blood demand and utilization practices among the delivery cases and suggest measures if any to improve the existing practices. Methods: The study was performed over two years; normal standard practice like in any other hospital is being followed. Urgent blood demand is requisitioned whenever there is an emergency like a patient having post partum hemorrhage or abruptio placenta etc. Blood demand forms, blood administration and delivery records were checked and analyzed. Results: 121 cases were given blood transfusion indicating the incidence as 2.67% among total delivery cases, blood transfusion among elective CS cases was 1.58% and 3.84% in emergency cesarean section; 2.82% of vaginal delivery were given blood transfusion for various unforeseen indications. Conclusion: In spite of taking all measures hemorrhage can still occur at times so perilous that it must be managed energetically and promptly. The mode of delivery has some influence on blood transfusion. It is suggested that blood demand could be restricted only to high risk cases both for normal delivery and CS. This will reduce the work load on blood banks and there by improve efficiency.

Juniper online journal of case studies, Feb 27, 2018

Fibroids uterus also called uterine leiomyoma are the most frequently encountered benign tumours ... more Fibroids uterus also called uterine leiomyoma are the most frequently encountered benign tumours of the uterus. Many fibroids are asymptomatic and are picked up on routine examination. Clinical features depend on number, size and location of the fibroids. Symptomatic fibroids may be managed medically or surgically. Hysterectomy by different routes is the commonest operation performed for fibroid uterus. Hysterectomy may not be the desired where uterus needs to be retained for different reasons. Removal of fibroids called myomectomy followed by reconstruction of uterus is the correct and desired mode of management in such cases. We report one such case where 29 fibroids of varying sizes were removed abdominally and uterus reconstructed in an unmarried girl who conceived spontaneously within one year of surgery after marriage. Vasopressin is effective in reducing the blood loss at the time of myomectomy. Mifepristone is a new mode of treating fibroids medically.

Journal of clinical case studies reviews & reports, Dec 30, 2021

Introduction: At present one of the major challenges our country is facing is population explosio... more Introduction: At present one of the major challenges our country is facing is population explosion, unintended and unwanted pregnancies. This is in spite of being the first country in the world to launch a family planning program. Long-acting, reversible family planning methods, such as intrauterine contraceptive devices, have been reported to be very effective. This is usually inserted as an interval procedure but can be inserted post-delivery also which has many advantages. Study was undertaken to find out the present status of this programme ten years after its initiation by the government. Materials and Methods: This observational study was conducted for three months at three large medical institutes. The participants were all labour cases admitted for delivery. Only willing cases were included; they were interviewed to find out their awareness, acceptance and planning for future contraception. Results and Observations: 3453 were willing to be part of the study. The study showed that a large number of women (23.5%) relied upon breast feeding as a method of spacing. Almost half of them (47.5%) were undecided regarding methods to delay the next pregnancy. 81% had heard about the device. 5.9% had some information regarding insertion after delivery. Only 9.1% cases remembered being told something specifically about insertion after delivery. Insertion was done in 3.5% cases, mostly with cesarean section. Discussion: Contraception is an important part of population control and prevention of unwanted and unintended pregnancies. In India, as in many other countries, postpartum family planning is usually initiated after 6 weeks postpartum. The postpartum period is an optimal time for effective contraception as the new mother is more receptive to accept family planning and the couple is of proven fertility. Though insertion of contraceptive device immediately after delivery is a good method of contraception but its awareness, acceptance and insertion is extremely low hence there is a great need of making concerted efforts to improve its acceptance and insertion. Counseling during antenatal period is the ideal time.

COJ Nursing & Healthcare, 2018

Outflow tract obstruction of female genital tract can lead to varied presentations depending on m... more Outflow tract obstruction of female genital tract can lead to varied presentations depending on many factors. Most of the obstructions are congenital and usually occur in the lower part. A rare case of obstruction of cervical opening is reported. 37 years old lady with two previous cesarean deliveries reported with complaints of lower abdominal pain along with difficulty in passing urine, she was detected to have a lower abdominal lump. Imaging studies suggested retention cyst. Examination under anesthesia showed obliterated external cervical opening. Dilatation resulted in extrusion of large quantity of chocolate material. She made good postoperative recovery but the cause of cervical stenosis was not clear.

Medical Journal Armed Forces India, 2017

Medical Journal Armed Forces India, 2015

Background: In spite of many available contraceptives numerous unwanted and unplanned pregnancies... more Background: In spite of many available contraceptives numerous unwanted and unplanned pregnancies occur. Though the couples desire contraception but are not able to accept it due to their ignorance and misconceptions. Intrauterine Contraceptive Device (IUCD); an effective contraceptive is usually inserted six weeks after delivery. It can be inserted within 48 h of delivery called postpartum insertion for which government has started the program in many states. The study was undertaken to find out the choices about contraception after delivery and awareness about postpartum insertion. Methods: The present observational study was conducted in one of the zonal service hospitals. 500 antenatal cases were included in the study. Their choice of contraception after delivery and awareness was determined through a questionnaire. Reasons for refusal of postpartum insertion were recorded. A small sample of staff also was included in the study. Results: 500 cases were included in the study, a large number had decided about contraception; mainly breast feeding supplemented by barrier contraceptive. 94 of 500 were willing for insertion of contraceptive device but not immediately after delivery due to apprehension in general and fear of side effects. Staff's awareness about postpartum insertion was poor. Conclusion: Knowledge and acceptance of postpartum insertion is very low among antenatal women; probably because the concept is new in the community. There is a strong need to increase the knowledge and awareness about this by health education and counseling.

Medical Journal Armed Forces India, 2012

Introduction: The rate of exclusive and early breastfeeding in India is only 64% (NFHS 5-National... more Introduction: The rate of exclusive and early breastfeeding in India is only 64% (NFHS 5-National Family Health Survey) even though WHO has suggested exclusive breastfeeding for 6 months. Breastfeeding plays a crucial role in the development of a newborn, not only physically but mentally as well. Most of the would-be Mothers spend maximum time with their mother or mother-in-law who has the biggest influence on counseling these new-to-be mothers. These grandmothers know the benefits of breastfeeding, the importance of a special diet, and proper hydration for good quality milk but report inadequacies in the treatment of breast complications and the need for exclusive breastfeeding till 6 months of life. Which is why we decided to explore the knowledge, attitude, and practices about exclusive breastfeeding among these grandmothers. Material and methods: A survey was done in Dr. D. Y. Patil Hospital Pimpri, in which 270 grandmothers were interviewed out of 309 deliveries in the hospital over a period of 3 months from July to September 2022. This study was done as a part of World Breastfeeding Week activities. A questionnaire was formed to ask grandmothers about antenatal and postnatal counseling, exclusive breastfeeding, early initiation of breastfeeding, the importance of colostrum, etc. Analysis of the collected data was done using percentages and represented diagrammatically. Results: It was observed that though 70% of grandmothers knew about the early initiation of BF, only 43% of patients actually initiated breastfeeding within one hour. The importance of colostrum is known by only 66% of grandmothers but colostrum feeding was encouraged by 81% of grandmothers. Almost all grandmothers knew about 6-month period of exclusive breastfeeding and it is practiced by most of them. A very minor 19.32% of mothers are counseled antenatally about breastfeeding while 90% of mothers are counseled postnatally by grandmothers. Conclusion: Breastfed babies seem to have better immunity and development than those fed by top feeds. The awareness about this is much less than what it should be. So, it is important to raise the awareness amongst community through the most powerful resources. So, interventions to promote exclusive breastfeeding should be tailored to the needs of each population by identifying the factors that influence the practice in a given context. Grandmothers have knowledge that has been validated by their experiences and can directly affect the new, would-be mothers and their breastfeeding practices. Clinical significance: These results indicate that there is a significant gap between knowledge and practices about exclusive and early breastfeeding and more active steps should be taken to change the attitude of grandmothers so that they will more actively and positively counsel the mothers to breastfeed. It is important to raise the awareness and implications of exclusive breastfeeding. Categories: Obstetrics and gynecology, Breastfeeding, Breastfeeding awareness.

Medical Journal Armed Forces India, 2018

Medical Journal Armed Forces India, 2016

Medical Journal Armed Forces India, 2017

Background: Ectopic pregnancy or extrauterine pregnancy will invariably result in abortion or rup... more Background: Ectopic pregnancy or extrauterine pregnancy will invariably result in abortion or rupture. Though there are risk factors for ectopic pregnancy, but at times the condition can occur without any apparent predisposing factor. Cases admitted with provisional diagnosis of ectopic pregnancy were included in this prospective study. Methods: Eighty suspected cases of ectopic pregnancy were incorporated in the study. The management was done based on standard practice. All the cases underwent urine pregnancy test, routine blood investigations including blood group, and transvaginal ultrasound. Serial bhCG was measured in cases where the diagnosis was not clear initially. Results: Incidence of ectopic was 2.46 per 100 deliveries; there was no apparent risk factor in 28.7% and many cases had more than one risk factor. 'Triad' of ectopic was present in only 21 cases. Sixteen cases were asymptomatic and two were admitted as emergency. Ultrasound findings were inconsistent and wide ranging. In 37 doubtful cases, bhCG was measured serially. There was one case of suspected interstitial pregnancy confirmed on laparoscopy. Twenty-seven cases were managed medically, and 9 were managed expectantly. Fortysix cases were managed surgically either by laparoscopy or by laparotomy. Salpingectomy was performed in 37 cases, and salpingostomy in 7 cases either laparoscopically or by laparotomy. Conclusion: Ectopic pregnancy can be managed by laparotomy, operative laparoscopy, and medically and occasionally by observation alone. Management must be customized to the clinical condition and needs of future fertility of the patient.

EC Gynaecology, Mar 16, 2020

International journal of clinical obstetrics and gynaecology, 2021

Background: Previous studies indicate that new-borns delivered by elective caesarean section are ... more Background: Previous studies indicate that new-borns delivered by elective caesarean section are more prone to respiratory morbidity after birth. Objective: To find out whether the mode of delivery is associated with the neonatal respiratory outcomes. Methods: In this observational study, following three groups of pregnant women (30 in each group) were included a) normal vaginal delivery b) elective LSCS and c) emergency LSCS. Respiratory morbidity (Tachypnoea, chest retraction, grunting, and nasal flaring) and APGAR scores were compared between three groups. Results: Respiratory morbidity was higher in elective and emergency LSCS groups compared to normal vaginal delivery group. However, the differences were not statistically significant. APGAR scores at 1 and 5 minutes were similar in three groups. NICU admissions were higher in elective caesarean groups as compared to the other two groups. Conclusion: Higher incidence of respiratory distress syndrome was noted in babies born to mothers who have undergone elective caesarean section.

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019

Background: Breastmilk is considered as one of the healthiest, nutrition-rich yet least expensive... more Background: Breastmilk is considered as one of the healthiest, nutrition-rich yet least expensive method of infant feeding. It is a universally accepted fact that breastmilk meets all the nutritional demands of the new-born. There are extensive benefits of breastfeeding for the new-born as well as for the nursing mother which have been documented from time to time.Methods: A multiple-choice questionnaire was used to interview the participants during data collection.Results: Using the IBM SPSS version 20 software, descriptive analysis of the categorical variables has been presented using frequency and percentage tables. Regarding the practices about breast feeding in primigravidas, their concepts about the same have been captured in this study.Conclusions: Though the knowledge about exclusive breast feeding was not extraordinary among the participants, they had a very favourable attitude towards the same. Almost all patients were also extremely receptive and inquisitive during the se...

Indian Journal of Obstetrics and Gynecology Research

Congenital anomalies can be due to various reasons. Some of these can significantly affect the vi... more Congenital anomalies can be due to various reasons. Some of these can significantly affect the viability of the fetus, some may impair quality of life subsequent to delivery and some may not have any significant effect. It is necessary to determine presence of congenital anomalies in-utero for better maternal and neonatal outcomes. Objectives: To determine presence of congenital anomalies in mothers visiting antenatal clinics by conducting a second trimester anomaly scan. Materials and Methods: The study evaluated 2000 mothers visiting antenatal care in D. Y Patil Medical College and Hospital in Pune. A second trimester anomaly scan was conducted between 18-20 weeks of gestation in all the patients. Results: The rate of fetal anomalies noted were 0.8% (16/2000 cases). 13 congenital anomalies were incompatible for viability of the fetus and hence were terminated. 3 congenital anomalies were minor in nature and hence continuation of pregnancy was advised. 2 mothers who were unbooked during antenatal period, delivered anomalous babies and were as well included in the evaluation. Conclusion: A second trimester anomaly scan should be made mandatory to identify any malformation in the growing fetus as we still have an option to terminate the pregnancy and save the family from the future setback. Also, with the advent of fetal medicine we can identify and treat the fetus in utero which might reduce the future complications. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Medical Journal Armed Forces India, 2016

Medical Journal Armed Forces India, 2016

Academic Emergency Medicine, 2002

Journal of South Asian Federation of Obstetrics and Gynaecology

Backround: Uterus didelphys with obliterated half-vagina and absent kidney on the same side is a ... more Backround: Uterus didelphys with obliterated half-vagina and absent kidney on the same side is a syndrome with very low incidence known as Herlyn-Werner-Wunderlich syndrome (HWW) and also known as obstructed half-vagina and ipsilateral renal anomaly (OHVIRA). 1,2 Case report: Sixteen-year-old female presented with cyclical pain in abdomen mostly from Day 1 on her periods since menarche since 1-2 years. She had regular menstrual cycle with dysmenorrhea. Clinical examination was done, and on ultrasound, we diagnosed it as HWW syndrome. Intraoperatively, a bulge was arising from right vaginal wall, and on left side, cervix was felt with normal size uterus. Incision was taken on the bulge, about 60cc of mucous discharge was drained. We confirmed uterine didelphys. Later suturing was done on the opening of the right vagina, to keep it patent. Conclusion: We should think of HWW syndrome in patients who have cyclic pain in abdomen and also in newborn cases with any renal abnormalities. Early and prompt surgical therapy prevents further complications. Clinical significance: Early diagnosis and treatment prevents complications such as endometriosis and infertility.

International Journal of Clinical Obstetrics and Gynaecology, 2021

Background: Previous studies indicate that new-borns delivered by elective caesarean section are ... more Background: Previous studies indicate that new-borns delivered by elective caesarean section are more prone to respiratory morbidity after birth. Objective: To find out whether the mode of delivery is associated with the neonatal respiratory outcomes. Methods: In this observational study, following three groups of pregnant women (30 in each group) were included a) normal vaginal delivery b) elective LSCS and c) emergency LSCS. Respiratory morbidity (Tachypnoea, chest retraction, grunting, and nasal flaring) and APGAR scores were compared between three groups. Results: Respiratory morbidity was higher in elective and emergency LSCS groups compared to normal vaginal delivery group. However, the differences were not statistically significant. APGAR scores at 1 and 5 minutes were similar in three groups. NICU admissions were higher in elective caesarean groups as compared to the other two groups. Conclusion: Higher incidence of respiratory distress syndrome was noted in babies born to mothers who have undergone elective caesarean section.

Medical Journal Armed Forces India, 2016

Background: Many women die while going through childbirth; hemorrhage being common cause for mate... more Background: Many women die while going through childbirth; hemorrhage being common cause for maternal mortality. Many maternal deaths can be saved by building up hemoglobin antenatally and timely blood transfusion. The transfusion may result in many complications hence the blood transfusion practices should be streamlined and adhered to and reviewed periodically. This retrospective study was undertaken at one of the tertiary care hospital to find out the blood demand and utilization practices among the delivery cases and suggest measures if any to improve the existing practices. Methods: The study was performed over two years; normal standard practice like in any other hospital is being followed. Urgent blood demand is requisitioned whenever there is an emergency like a patient having post partum hemorrhage or abruptio placenta etc. Blood demand forms, blood administration and delivery records were checked and analyzed. Results: 121 cases were given blood transfusion indicating the incidence as 2.67% among total delivery cases, blood transfusion among elective CS cases was 1.58% and 3.84% in emergency cesarean section; 2.82% of vaginal delivery were given blood transfusion for various unforeseen indications. Conclusion: In spite of taking all measures hemorrhage can still occur at times so perilous that it must be managed energetically and promptly. The mode of delivery has some influence on blood transfusion. It is suggested that blood demand could be restricted only to high risk cases both for normal delivery and CS. This will reduce the work load on blood banks and there by improve efficiency.