Abstract

Background: Endometrium is the most sensitive indicator of ovarian function and endometrial biopsy is one of the most important investigations in infertility. The current study was carried out to investigate the histomorphological patterns of endometrium in infertile women and to compare the results with other similar studies.

Materials and Methods: A cross-sectional study on 2,080 infertile women was carried out to find the incidence of various histomorphological patterns in hematoxylin-eosin stained sections of endometrium and compare them with other Indian studies.

Results: In the current study majority of cases (88.50 %) were of primary infertility; the highest number of cases was in the age group of 21–30 years and the oldest patient was of 50 years age. The various abnormalities observed were anovulatory endometrium (15.75 %), inadequate proliferative (1.90 %), inadequate secretory (9.52 %), glandulostromal disparity (GSD) (4.21 %), hyperplasia (1.10 %), and endometritis (1.63 %). In 3.0 % cases menstrual cycle history was not available and curettage was done at inappropriate period of the cycle in 11.63 %. Comparison with other studies revealed the results matching with some and differing with others.

Conclusion: In the current study, anovulatory endometrium and luteal phase defect are the major causes of infertility, and tuberculous endometritis, non-specific endometritis and GSD are minor contributing factors. These are treatable causes. Premenstrual endometrial biopsy, if accompanied by information of menstrual cycle and date of biopsy, can be a very reliable diagnostic tool for hormonal dysfunction and
intrinsic endometrial factors in infertility.

Abstract

Approximately, one fourth of women have leiomyomas. Leiomyomas are benign tumors that originated from smooth muscle cells. Estrogen is claimed to relate as a cause but exact mechanism has not fully understood. In this study, 95 leiomyoma cases that have been diagnosed by our department in years between 2010 and 2012 were examined. Age ranges of patients, sizes, locations, and numbers of leiomyomas were identified. Immunohistochemically ER (estrogen), PR (progesterone), and Gross cystic disease fluid protein-15 stains were performed to the paraffin blocks and their percentages of staining were noted. Statistically, submucosal and intramural locations were significantly related to ER and PR (p\0,001). There were significant relationship between ER and PR in 30–50 years age group (p\0,001). There were significant relationship between ER, PR and locations (p\0,001), numbers (p\0,001), sizes of leiomyomas (below 5 cm; p\0,001), (between 5 and 10 cm; p = 0,037), larger than 10 cm; p = 0,002). Consequently, relationship between leiomyoma and ER, PR were revealed in this study. Also, relationship between leiomyoma locations and patient ages were identified statistically. There was no immunoreactivity with GCDFP-15 in leiomyomas.

Abstract

Aim: Aim of this study is to find out clinical relevance of estimating PON1 arylesterase activity, total oxidative stress (TOS), nitric oxide (NO), and vitamin C levels in maternal serum for prediction of birth weight of newborn.

Methods: We have investigated the PON1 arylesterase activity, TOS, NO, vitamin C, total protein, and albumin levels in 56 postnatal clinic patients having newborn weighing < 2500 gm (low birth weight) and compared with 56 postnatal clinic patients having newborn weighing > 2500 gm. Samples were collected immediately after delivery.

Results: PON1 arylesterase activity levels show significant decrease in cases as compared to controls (93.27 ± 13.76 kU/l vs. 112.77 ± 9.42 kU/l). Nitric oxide (nitrate ? nitrite) levels are also found to be significantly decreased in cases with respect to controls (22.89 ± 2.65 umol/l vs. 24.73 ± 3.80 umol/l). Total oxidative stress is significantly increased in cases than in control subjects (23.34 ± 2.64 lmol H2O2 equiv./l vs. ± 21.43 ± 2.47 lmol H2O2 equiv/l). Vitamin C levels are also significantly decreased in cases as compared to controls (1.23 ± 0.25 mg/dl vs. 1.34 ± 0.28 mg/dl). Positive correlation between neonatal birth weight and maternal serum PON1 arylesterase activity (r = 0.682, p\0.05) while negative correlation is obtained between neonatal birth weight and maternal serum oxidative stress (r = -0.478, p< 0.05). Logistic regression analysis is applied for assessing predictive utility which demonstrated a significant association of birth weight with PON1 arylesterase activity (AUC = 0.960, Naglekerke’s R2 = 0.793, p< 0.05)

Conclusion: Decreased arylesterase activity and antioxidant vitamin C levels with increased total oxidative stress in maternal serum may be considered as the additional risk factors for the development of low birth weight newborn.

Abstract

Objective: This study compares the efficacy of sequential clomiphene citrate (CC) ? Gonadotropin to that of Gonadotropin alone with ultrasound monitoring.

Methods: It is a retrospective analytic study done on a total of 100 couples to compare two groups receiving CC ? Gonadotropin and Gonadotropin alone for ovarian stimulation followed by intrauterine Insemination (IUI). We studied the cycle performance parameters. Cumulative pregnancy rates and ovulation rates were the primary outcomes. Results were analyzed following the intention-totreat principle.

Results: There were no significant differences with respect to indications and the numbers of dominant follicles recruited. The endometrial thickness was significantly better in Gonadotropin-alone group (P < 0.05). Ovulation rate was better for CC ? Gonadotropin at 95.91 %. Nine pregnancies were in the CC ? Gonadotropin group (18.36 %) and 17 in Gonadotropin-alone group (33.3 %).

Conclusions: Significant differences in pregnancy rates and endometrial thickness were seen. Gonadotropin alone thus appears to give better results, but CC ? Gonadotropin seems to be a cost-effective drug.

Abstract

The purpose of this study: This study was undertaken to evaluate the role of positron emission tomography–CT (PET–CT) in diagnosis and management of gynecological malignancies in primary and recurrent settings and also to investigate its role in inappropriately treated patients, for pretreatment evaluation (staging) to help in proper therapeutic management.

Method: This is a retrospective study of 56 patients of gynecological malignancy registered in Gujarat Cancer Research Institute from June 2011 to December 2013.

Results: Out of 56 cases where PET was done, the results were as follows: carcinoma cervix—23, carcinoma ovary—20, carcinoma endometrium—9, carcinoma vulva— 1, carcinoma vagina—2, and GTN—1. PET scan was negative in 37 % of patients where CT scan was suspicious, which changed the therapeutic modality and prevented further unnecessary interventions. In cases where clinical suspicion of recurrence was high based on rising tumor marker and CT scan was negative, subsequent PET– CT was able to pick up malignancy in 75 % cases. Eleven patients (25 %) with suspected recurrence with inconclusive CT scan and negative PET–CT scan were kept on follow-up, thus reducing further morbidity and cost.

Conclusion: Addition of PET-CT, a noninvasive method to the oncologist’s imaging armamentarium may ultimately improve both outcomes and costs by altering management strategies in primary and recurrent settings. The potential use of PET–CT appears promising in several decisionmaking steps in the management of patients with gynecological malignancy. It defines the extent of metastatic disease which enables the clinician to decide regarding salvageable surgical intervention or palliative measures.

Abstract

Introduction: Advanced fertilization techniques like frozen embryo transfer (FET) and assisted reproductive technology have become popular and commonly used methods to treat patients suffering from infertility. Incidences of infertility are on a rise due to increased representation of females in the work place, delay in marriages, stress, and ignorance.

Methods: We performed this prospective therapeutic study to compare FET and fresh embryo transfer in the treatment of infertility in terms of conception rate, patient acceptance, complications, and patient’s compliance. A prospective screening therapeutic study on 108 patients, from September 2013 to September 2014 in Karnataka, India, randomized the patients into 2 groups (n = 54), Group-I treated with day-3 FET while Group-II was treated with fresh embryo transfer, after performing ICSI.

Results: In 108 patients, 45 % patients were within 35 years of age, 35 % were in the age group 35–39. Significantly, 22 (40.75 %) patients treated with FET conceived (P = 0.022), whereas 16 (29.63 %) patients treated with fresh embryo transfer conceived (P = 0.59).

Discussion: There is limited published literature from the subcontinent, comparing techniques like FET and embryo transfers in the treatment of infertility. Awareness and economic reforms must be formulated in India to facilitate individuals facing infertility problems to conceive.

Conclusion: FET has better and significant conception rates compared to fresh embryo transfers. FET shares an advantage of providing good quality embryos for future and subsequent implantations in cases of failure. Patient counseling and motivation play a pivotal role in the success of therapeutic procedure.

Abstract

Study Objectives: This meta-analysis was performed to compare the outcomes between NACT-S andRT for locally advanced cancer cervix. The primary end points were survival benefits.

Searching Method: The data sources for the search included medline, national library of medicine, and the embase search engines. Inclusion criteria included studies published between 2000 and 2012, and FIGO stages IB2 to IVA. Studies had to be properly randomized, prospective, or retrospective and only phase III. Further, the studies had to be with two arms, including one arm for neoadjuvant chemotherapy then-surgery (NACT-S), and the other arm for radiotherapy (RT).

Results: Data were collected from 1171 patients enrolled in seven phase III trials. The 5-year PFS (progression-free survival) for NACT-S and RT were 62 and 45.5 %, respectively. The 5-year OS for NACT-S and RT were 66 and 49 %, respectively. NACT-S was associated with better late toxicities compared to RT.

Conclusion: NACT-S is a reasonable treatment option for locally advanced cancer cervix. It achieved better results than RT, especially for stages from IB2 to IIB.

Abstract

Introduction: Although the incidence of cancer cervix has reduced in India during the last two decades, still most of the patients presenting in tertiary care centers are in advanced stages.

Material and Methods: At this center, we see 6% of cancer cervix cases every year, and most of these cases are in stage III and IVa. All these patients have squamous cell carcinoma and were treated with a combination of external and intracavitary radiotherapy along with concurrent cisplatin given once weekly. Eightynine point nine % patients had achieved a complete response.

Results: Local recurrence was seen in 17.9% at a median duration of 10.5 months, and 8.17% developed distant metastasis involving lung, liver, bone, and supraclavicular lymph nodes. Three patients developed metastasis at unusual sites involving breast, paraspinal muscles, and duodenum which are very rarely involved. These patients were treated with chemotherapy using carboplatin and Paclitaxel combination but succumbed within 8–10 months of development of metastasis.

Conclusion: The cause of involvement of these unusual sites is not clear, but it may be hematological spread, and we want to share these reports such that these sites are seen during follow-up of patients of cancer cervix.

Abstract

Background Primary vaginal carcinoma is rare, accounting for 1–2 % of all gynecological malignancies. Being rare, most observations are based on retrospective and comparative analyses. This study was aimed to retrospectively analyze the prognostic factors and its relevance in the outcomes of primary vaginal cancers.

Materials Medical records of all cases of primary vaginal cancers, presented to Department of Oncology, from 2004 to 2012, at a tertiary care center in southern India, were retrieved from electronic medical records, and were analyzed.

Results The total number of cases was 32. Median age at presentation was 64.28 years. Squamous histology accounted for 84.4 %, with the rest being adenocarcinoma. Surgery was offered for five (15.6 %), and concurrent chemotherapy for 14 (43.8 %) patients. Three patients had only surgery. All others received radiotherapy. Twenty received external beam radiation (EBRT) and vaginal brachytherapy (VBT); seven only EBRT and two, adjuvant radiation. Five patients had residual disease; two, stage III, and three stage IV. Median follow-up was 55.83 months. Twelve patients were alive at last follow-up (37.5 %), while 14 were dead (43.8 %—8 of disease and 6 of other causes). Six patients were lost to follow-up (18.8 %). Twenty patients were disease free. Seven had recurrence, three loco-regional and four distant. Median overall survival (OS) was 86.1 months, disease-free survival (DFS) 90.17 months, and disease-specific survival (DSS) 97.13 months. When well and moderately differentiated tumors were taken together, the 5-year OS, DFS, and DSS rates were, 56.6, 64.3, and 82.3 %. For poorly differentiated tumors, median OS, DFS, and DSS were, 20.9, 14.6, and 20.9 months, with statistically significant advantage for better grade tumors, for DSS (p 0.050). Better 5-year OS, DFS, and DSS rates were observed for stage I ? II group, with 54.9, 79.8, and 78.9 %, compared with advanced stage where the same were 54.8, 38.2, and 68.6 % (DFS—p 0.003, DSS—p 0.009). Grade and stage of tumor had statistically significant predictive value over the outcomes, while tumor size showed a significant trend. Patients treated with combination of EBRT and VBT fared well.

Conclusion Our study could conclude that grade of differentiation was a significant predictor of poor survival as was stage of disease. Combination of VBT and external beam radiotherapy provides good DFS.

Abstract

Aim The data of survival for Indian cervical cancer patients treated by indigenous modifications of the protocol are scarce. The objective of this retrospective study was to analyze the efficacy and tolerability in patients of cervical carcinoma treated by neoadjuvant chemotherapy followed by concurrent chemoradiation.

Materials and Methods Three hundred and thirty two cases of squamous cell carcinoma of cervix who received 3 cycles of neoadjuvant chemotherapy followed concurrent chemoradiation were retrospectively analyzed for overall survival (OS), disease-free survival (DFS), and local pelvic control rate.

Results The 3-year OS and DFS were 93.7 % for stage I-B, 88.0 and 84.0 % for stage II-A, 82.8 and 79.7 % for stage II-B, 70.0 and 64.9 % for stage III-A, 59.3 and 52.4 % for stage III-B, and 53.6 and 32.1 % for stage IV-A disease. The 5-year OS and DFS rates were 93.7 and 87.5 % for stage I-B, 84.0 % for Stage II-A, 79.7 and 76.6 % for stage II-B, 67.6 and 59.5 % for stage III-A, 48.4 and 41.9 % for stage III-B, and 28.6 and 14.3 % for stage IV-A disease.

Conclusion Neoadjuvant chemotherapy followed by concurrent chemoradiation is feasible and produces impressive disease-free and overall survival. This protocol is especially helpful for busy cancer centers with long waiting lists on radiotherapy machines.

Abstract

Study objective: The objective of this study was to prospectively analyze the risks and benefits of total laparoscopic hysterectomy (TLH) compared with total abdominal hysterectomy (TAH) and the effects of learning curve on them over 4 years (March 2010–April 2014).

Design: It was a prospective randomized study.

Setting: The study was conducted in Delhi government hospital which had no staff with previous experience of advanced laparoscopic surgeries.

Patients: Two hundred fifty patients were operated on for benign gynecological conditions (35–65 years). The numbers of cases operated laparoscopically were as follows— 22 in 2010, 25 in 2011, 32 in 2012, and 46 in 2013. Equal number. of patients operated by open surgery were taken in the study during the same time period.

Results: Two hundred fifty cases were operated since March 2010, by either laparoscopic or open surgery. Incidence of major complications was—1.6 % for TLH compared to 4 % in TAH. After the first year of surgery, this incidence has fallen to 0 % in subsequent years in TLH group. The incidence of minor complications declined from 14 to 4.5 % in the third year of study. Total rate of conversion to laparotomy was 9.7 %, which again had a significant decline after the first year. TLH also clearly showed superior benefits of less intraoperative blood loss, early postoperative ambulance, and shorter period of hospital stay in comparison with TAH.

Conclusion: The study has led us to conclude that TLH is a safe, effective, and reproducible technique after the completion of a period of training necessary to standardize the procedure. This approach must be established in our real, day-to-day clinical practice.

Abstract

Background: The present study summarizes the results of treatment in the form of disease-free survival and overall survival in bulky stage IB2 and locally advanced (stages II–IVA) squamous cell carcinoma of the uterine cervix. The treatment has been given in the form of NACT followed by CCRT in one arm and CCRT in the other arm.

Materials and Methods: This retrospective study analyzed 713 cervical cancer patients who were treated at our center during 2007 and 2008; out of 713 patients, data of 612 patients have been compared. The patients’ data were analyzed retrospectively. Patients had undergone PF 28.6 %, TPF 21.5 %, and only CCRT 49.9 %. Majority of patients were in the age group 41–50 years, while stage wise, mainly stage IIIb and IIb. Disease-free survival was observed on the basis of stage and NACT. The survival analyses were performed using the Kaplan–Meier method. All statistical calculations were done with SPSS Statistics version 20.0.

Results: For cancer cervix NACT versus CCRT, the DFS rate was at 5 years (58.3 vs. 41.8 % p = 0.001). NACT followed by CCRT demonstrated significantly superior DFS as compared to definitive CCRT, respectively, TPF (hazard ratio (HR) = 0.248, 95 % confidence interval (CI) 0.123–0.500; p < 0.001), PF (HR = 0.445, 95 % CI 0.266–0.722; p = 0.002). The results of univariate stage, age, and multivariate study show that stage hemoglobin level, interval between external-intracavitary radiation, and type of neoadjuvant chemotherapy were the factors affected survival cervical patients treated with radiation. The grade 3/4 hematologic toxicities were more in the NACT group than CCRT (p < 0.001) while the non-hematological toxicity was not significant; the TPF group experienced more toxicity than PF (p = 0.029). This treatment regimen is feasible as evidenced by the acceptable toxicity of NACT and by the high compliance to radiotherapy. The grade 3/4 hematologic toxicities were more inNACT groups than CCRT (p < 0.001); the TPF group experienced more toxicity than PF (p = 0.029).

Conclusion: TPF/PF as NACT is feasible and produces impressive responses in cancer cervix.

Abstract

Objective: To study the incidence of septic abortion, reasons for that, sociodemographic profile, abortion providers, complications faced, and treatment given and its outcome.

Methods: All the women with septic abortion admitted at Government Maternity Hospital, Tirupathi, over a period of 2 years 4 months duration from July 2007 to October 2009 were studied prospectively.

Observations and results: Incidence of septic abortion in our study was 6.78 %. 72 % of cases were performed by qualified medical personnel. Fourteen patients had complications, among them peritonitis, pelvic abscess, renal failure, and septic shock were common. Twenty-six patients had Grade-I sepsis, Grade-II: 8, Grade-III: 4, and Grade-IV: 4. Laparotomy was done in six cases. There was no mortality in our study.

Conclusion: The tragedy of septic-induced abortion is totally preventable. It only needs definitive commitment to women’s health by providing effective contraception, strengthening the family welfare services, and discouraging repeated terminations of pregnancy as contraceptive method.

Abstract

Aims: Gestational trophoblastic neoplasia (GTN) comprise a spectrum of interrelated conditions originating from the placenta. With sensitive assays for human chorionic gonadotropin (b-hCG) and current approaches to chemotherapy, most women with GTN can be cured with preservation of reproductive potential. The purpose of this analysis was to address the outcome of GTN in patients from a tertiary care center of India.

Materials and Methods: We undertook a retrospective and prospective review of GTN cases treated at our center over a period of 7 years from 2008 to 2014. Patients of GTN were assigned to low-risk or high-risk categories as per the FIGO scoring system. The low-risk group was treated with combination of actinomycin-D and methotrexate and the high-risk group received the Etoposide, Methotrexate, Actinomycin-D/ Cyclophosphamide, Vincristine (EMA/ CO) regimen. Salvage therapy was Etoposide, Paclitaxel / Paclitaxel, Cisplatin (EP/TP). Treatment was continued for three cycles after normalization of b-hCG level, after which the patients were followed up regularly.

Results: In total, 41 GTN patients were treated at our institution during the above period; 17 were in the low-risk and 24 were in the high-risk category. The lung was the most common site of metastasis. All low-risk patients achieved complete remission. Among high-risk patients, one patient died while receiving first cycle chemotherapy, one patient relapsed, and 22 patients achieved complete remission. The single relapsed patient also achieved remission with second-line chemotherapy.

Conclusion: Risk-stratified treatment of GTN was associated with acceptable toxicity and resulted in outcome that was comparable with international standards. The use of two-drug combination in low-risk patients is a better option especially in developing countries.

Abstract

Introduction: Cervical cancer is the most common cancer among Indian women. Only 5 % of women in developing countries have ever been screened for cervical abnormalities.

Objectives: To study the correlation of cytology and colposcopy in VIA-positive women attending the Gynaecology clinic.

Materials and Methods: This prospective cross-sectional study on 200 symptomatic women compares the role of cytology and colposcopy in the assessment of subjects testing positive for acetowhite lesions on the cervix after application of 5 % acetic acid (VIA).

Results: 200/637 women screened in OPD tested VIA positive, giving a positivity rate of 31 %. Six smears were reported as LGSIL or HGSIL giving a cytological abnormality rate of 3 %. The association between cytology and Reid’s score was statistically significant at a p value of 0.02. Of the 4 cases with biopsy-confirmed invasive cancer, cytology reported 2 as LGSIL and 2 as HGSIL. Colposcopy reported all these women as CIN 2/3.

Conclusion: The accuracies of Pap smear cytology and colposcopy in the diagnosis of precancerous and cancerous lesions of cervix were good.

Abstract

Purpose: Hyperemesis gravidarum is the third leading cause of hospitalization during pregnancy. 5-HT3-receptor antagonists are the most effective against chemotherapyinduced nausea and vomiting and radiation. This randomized study aimed to compare and evaluate the efficacies of granisetron and promethazine for controlling nausea and vomiting of pregnancy.

Methods: The included patients were administered (oral and intravenous) granisetron and promethazine randomly. The patients were evaluated for nausea and vomiting by a senior gynecology resident blinded to designated drugs.

Results: This study revealed that granisetron significantly decreased nausea and vomiting in pregnant women (p < 0.05). Greater patient satisfaction and lesser adverse drug reactions in women receiving granisetron observed in this study suggest that it can be introduced as a more effective and safer drug in comparison with promethazine.

Conclusions: Considering the prevalence of nausea and vomiting of pregnancy and hyperemesis gravidarum, we can state that it is a health-related problem with economic, social and psychological dimensions. All efforts especially simple outpatient strategies to reduce its severity will help the pregnant woman continue her pregnancy with more satisfaction.

Abstract

Objectives: To study the various predictors of success for vaginal birth after cesarean (VBAC) and to study the maternal and fetal outcomes in them and their comparison with control group.

Methods: This prospective observational study included 100 women with previous cesarean section in the study group and 100 primigravidas in the control group. Various predictors for success of VBAC were analyzed and maternal and fetal outcomes were compared with the control group using student t test, Pearson v2 test, and Mann–Whitney U test.

Results: Of 100 women with prior cesarean Sect. 65 had successful trial of labor, while 35 underwent a repeat cesarean section. Maternal complications in the previous CS group were 15 % as compared to only 2 % in the control group (p\0.001).

Conclusion: Maternal pre-pregnancy BMI, non-recurring indications of previous cesarean section, good Bishop’s score at the time of admission, spontaneous onset of labor, and neonatal birth weight were significantly related to high chances of success of vaginal birth after previous cesarean section. Maternal complications were more common in study group, but the fetal outcomes were similar.

Abstract

Objective: To compare the efficacy and safety profile of two methods of labor induction i.e., intracervical dinoprostone gel (0.5 mg 8 h) and misoprostol (50 lg 4 h) for induction of labor in women with a poor Bishop’s score.

Design: Observational study.

Study Period: January 1st, 2009 to December 31st, 2010.

Population: A total of 329 women with unfavorable cervices induced at or near term.

Methods: Two cervical ripening agent study armswere used: dinoprostone gel (193women) and misoprostol (137women).

Main Outcome Measures: Induction to delivery interval, cesarean section, incidence of meconium stained liquor, FHR pattern, incidence of uterine hyperstimulation, and neonatal outcomes.

Results: The induction to delivery interval was significantly shorter in the misoprostol group as compared to the dinoprostone group (p\0.001). There was no difference in cesarean section rates between the two groups (dinoprostone gel 43 %; misoprostol 33 %; p = 0.144). The incidence of non-reassuring fetal heart rate pattern, meconium stained liquor, and uterine hyperstimulation were equivalent in both the groups (p = 0.529; 0.733; and 0.321, respectively). The neonatal outcomes in both the groups were comparable in terms of Apgar scores at birth (p = 0.160) and NICU admissions (p = 0.951).

Conclusions: Labor induction in women with unfavorable cervices results in high caesarean section rates. However, the use of misoprostol significantly reduces the induction to delivery interval, without adversely affecting the caesarean section rates and neonatal outcomes. Hence it may become a cost-effective alternative to dinoprostone gel in resourcepoor settings like India.

Abstract

Purpose: Preterm labor is a leading cause of neonatal morbidity and mortality. Ascending lower genital tract infection leads to preterm labor and adverse pregnancy
outcomes. This prospective case–control study was performed to see the association between preterm labor and urogenital infections.

Methods: A total of 104 women were observed for urogenital infections and their association with preterm labor. Case Group I included 52 women with preterm labor after 26 weeks and before 37 completed weeks of gestation with or without rupture of membranes. Control Group II included 52 women at completed or more than 37 weeks of gestation with no history of preterm labor, matched to the case group with respect to age and parity. Midstream urine was sent for cytology and culture sensitivity. Samples from posterior fornix of vagina were taken with two sterilized swabs under direct vision using Cusco/Sims speculum before first vaginal examination and were studied for gram stain characteristics and culture sensitivity by standard methods. Microorganisms isolated on culture were noted, and antibiotics were given according to sensitivity. Data collected were analyzed according to the groups by v2 test for categorical variables.

Results: In our study, urogenital infection was seen in 19 women in Case Group I (36.54 %) compared with 9 women in Control Group (17.3 %), and the difference was statistically significant (p 0.027).

Conclusion: Recognizing and treating the women having urogenital infections at a stage, when it has not become clinically evident, will decrease the percentage of women going into preterm labor and will improve the perinatal outcome.

Abstract

Background: Congenital Adrenal Hyperplasia (CAH) is a disorder an ideal candidate to deserve newborn screening. CAH accounts for a significant mortality and morbidity in India, and its awareness among obstetricians should be treated as highly important to prevent the problem.

Purpose of the Study: It is very important for a country like India as the incidence of CAH is reasonably high justifying screening program. However, there are simple logistics that need to be followed, and the treating physicians need to be aware of, if one has to reduce the number of false positives and recalls.

Methods: This article takes one through the steps involved in the analysis, interpretation, and reasons for false positives, why the false positives, so that unnecessary calls to parents for repeat sampling are minimized along with the emphasis and the need for the routine screening for CAH.

Results/Conclusion: The results of samples can vary depending on the gestational age of the baby, weight of the baby, sampling time, and the knowledge of these data to the treating Obstetrician and Pediatrician is of paramount importance in preventing repeat samples and frustration for the family and the people involved.