Clinical outcome of post placental IUD CuT380 insertion in terms of expulsion

Background: Insertion of an intrauterine contraceptive device (IUD) immediately after delivery has been recommended by the World Health Organization (WHO), as one of the safe and effective methods of temporary contraception. In the immediate post delivery period the women are highly motivated and need an effective method for contraception so that the child can be brought up with a relaxed mind without the worry of unintended pregnancy. This approach is more applicable to our country where delivery may be the only time when a healthy woman comes in contact with health care personnel. However, immediate post-partum IUD insertion may have disadvantages as well. The risk of spontaneous expulsion may be unacceptably high.Methods: After taking approval from hospital ethical committee, all women planning vaginal delivery desiring IUD, admitted through OPD and emergency were evaluated in detailed on design Performa Performa include patient’s identity, age, parity, gestational age, no of alive children, outcome and timings of insertion. Informed consent was obtained. With aseptic precautions IUD was inserted with kellys forceps in the uterine cavity up to the fundus, then cervix was examined for thread (that should not be visible at cervix if proper insertion done). The procedure was performed by myself. Patients were followed at 6week by examining the threat of IUD. All the information was recorded by myself. Follow up was done by taking patients contact number.Results: In our study, out of 300 cases, 63.67% (n=191) were between 18-30 years of age while 36.33% (n=109) were between 31-40 years of age, mean+sd was calculated as 29.49+4.62 years, mean gestational age was calculated as 38.53+0.94 weeks, mean parity was calculated as 3.49+1.06 paras. Frequency of expulsion in post placental intra uterine device cuT 380 insertions reveals in 8.67% (n=26).Conclusions: We concluded that the frequency of expulsion in post placental intra uterine device cuT 380 insertions is not significantly higher and appears to be safe and effective method of contraception.

Individual Healthcare and Socially Constructed Identities: Cases of Women Suffering from Cardiovascular Diseases (CVDs)

Study aims at examining socio-cultural factors in the form of personal perception of the respondents towards Cardiovascular Diseases (CVDs) and the resultant impact of this perception on the CVDs management regimen of the respondents. Social construction of illness is used to investigate these factors. Entire data were collected at Superspeciality Hospital, Jammu (India) and 41 personal interviews were conducted. Field research also consisted of observations which was done by employing purposive sampling method. Results demonstrate that factors like inability to carry out household chores, financial constraints, lethargy etc. have a bearing on the care seeking behavior of the respondents. Women constantly juggle between maintaining family equilibrium and maintaining their health. Socially constructed image of a healthy woman is somewhat difficult to achieve even if technologies of the self and anatomo-politics come into play because gendered nature of healthcare in India makes it difficult for these women to prioritize their health needs.

Prenatal Noninvasive Trio-WES in a Case of Pregnancy-Related Liver Disorder

Liver disease in pregnancy may present as an acute condition related to the gestational period, characterized by pruritus, jaundice, and abnormal liver function. The disease may be misdiagnosed with other liver diseases, some of which may have consequences for fetal health. It is therefore advisable to implement rapid diagnostic strategies to provide information for the management of pregnancy in these conditions. We report the case of a healthy woman with a twin pregnancy from homologous in vitro fertilization (IVF), who in the third trimester presented jaundice and malaise. Biochemical investigations and liver hyperechogenicity raised the suspicion of acute fatty liver disease of pregnancy (AFLP). Non-invasive prenatal whole-exome sequencing (WES) in the trio identified the Phe305Ile heterozygous variant in the ATP8B1 gene. Considering the twin pregnancy, the percentage of the variant versus the wild allele was of 31%, suggesting heterozygosity present in the mother alone. This analysis showed that the mother was affected by benign recurrent intrahepatic cholestasis of pregnancy (ICP1: # 147480) and indicated the opportunity to anticipate childbirth to avoid worsening of the mother’s health. WES after the birth of the twins confirmed the molecular data.

A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE REGARDING MENSTRUAL BLOOD BANKING AMONG NURSING STUDENTS AT JODHPUR

Introduction: Menstruation is a periodic cycle which occurs after every 28-30 days in every healthy woman after menarche till menopause. In recent years, this blood is considered as best out of waste as pluripotent stem cells can be collected from it. In addition to this, it could be saved for future benefits. In this study, an attempt has been made to rule out nursing student’s cognizance regarding menstrual blood banking. Aim of the study: To assess the knowledge regarding menstrual blood banking among nursing students at Jodhpur. Material and Method: A descriptive study was carried out on 180 nursing students of Government Nursing College, Jodhpur. Non-probability purposive sampling method was used to select samples. Study was conducted from 17th September to 17th October’2020 using structured knowledge questionnaire. Moreover, study was analysed by using descriptive and inferential statistics. Result: The findings of the study reveals that majority (58.03%) of the nursing students had moderate knowledge regarding menstrual blood banking. Furthermore, the study illustrated a significant association between level of knowledge and selected socio- demographic variables. Conclusion: It can be reiterated that nursing students have an average knowledge regarding menstrual blood banking. KEY WORDS: Knowledge, menstrual blood banking, menstruation.

Coexistent molar pregnancy with a normal fetus-a rare presentation of gestational trophoblastic disease

A coexistent molar pregnancy with a normal fetus is rare, with an incidence of 1 in 22.000 to 100.000 pregnancies-only 200 cases reported in the last two decades. The ultrasound is essential for an earlier diagnosis, and the management of these cases is challenging due to the increased risk of obstetrics complications and the possibility of posterior gestational trophoblastic neoplasia. Here we describe a 33-year-old healthy woman with a first-trimester twin pregnancy, presented with a normal fetus and a heterogeneous and vacuolar structure suggestive of complete hydatidiform mole. The pregnancy was interrupted, and a histological diagnosis confirmed complete hydatidiform mole in dichorionic/diamniotic twin pregnancy at 14 weeks. Molar twin pregnancy is a rare condition, and do not exist any consensus protocol to guide the clinical approach, so the decision to continue the pregnancy depends on the couple’s desire and maternal and fetal complications.

A rare case report of cornual pregnancy

Cornual pregnancy is a rare type of ectopic pregnancy in which embryo implants in the junction between the fallopian tube and uterus. Ectopic pregnancy is more common in the ampullary region of the fallopian tube. However, cornual (interstitial) pregnancy is seen in 2-4% of ectopic pregnancies. It is more dangerous than other ectopic as it may lead to catastrophic hemorrhage, shock with mortality rate of 2-2.5%. A cornual pregnancy is diagnosed at 7+3 week of amenorrhea in 27-year-old healthy woman. Ultrasound examination showed a right live cornual pregnancy with CRL corresponding to 6+4week of gestation with fetal heart pulsation. We performed right cornuostomy by laparotomy without any immediate or delayed postoperative complications. Cornual pregnancy poses significant diagnostic and therapeutic challenge; early diagnosis may help to select the proper management and treatment according to the clinical presentation, hemodynamic stability, serum b-hCG level and ultrasound findings. Early diagnosis and management remain the mainstay for tackling maternal mortality due to cornual pregnancy.