Rajal Thaker

Abstract

Introduction: Many adolescent girls with menstrual disturbances never present to their family doctor or gynaecologist due to embarrassment about discussing menstruation and fear of disease. This may lead to delayed presentation. The objective of the current study was to evaluate the socio-demographic aspects of adolescent girls having menstrual problems as well as type of menstrual problems and its management. This retrospective study was carried out at the department of obstetrics and gynaecology of tertiary care teaching hospital from July 2019 to July 2020. Results: Total of 141 adolescent girls visited our hospital with menstrual problems. Amongst them 90(63.8%) belonged to the late adolescent group, 135(95.7%) were residing at urban areas, 70(49.6%) were from middle socio-economic class and 126(89.3%) were unmarried. Dysmenorrhoea, menstrual irregularities and amenorrhoea were present in 86(61%), 38(27%) and 17(12%) respectively. Patients were managed either medical and/or surgical management along with proper counselling. Conclusion: Majority of the adolescent girls in our study were anaemic. Hence, prevention and management of anaemia along with health education regarding normal physiology, various menstrual problems and importance of nutrition is necessary. In India attempts and success to develop adolescent-friendly health services in public and private systems have met with partial success. Hence, counselling and management of menstrual problems in adolescents needs to be provided in existing health and medical care services.   Keywords: Adolescent, Amenorrhoea, Anaemia, Dysmenorrhoea, Menstrual problems.

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Abstract

Introduction: Stillbirth is a major obstetrical complication and devastating experience for parents as well as obstetricians. Identification of causes of stillbirth will be helpful in counselling of parents as well as formulating preventive measures. Objectives of current study were to study the prevalence, causes of stillbirth and associated complications to suggest preventive measures. Study Design: This retrospective observational study was carried out from July 2018 to June 2019 at a teaching tertiary care hospital. Results: Total number of birth during the study period was 6587 and total number of stillbirth was 109, hence prevalence of stillbirth was 16.5 per 1000 total births. Majority of patients 41(37.6%) belonged to maternal age group of 20-24 years of age. Majority of patients 73(67%) were multigravida. Majority 72(66.0%) were emergency admissions. Majority of stillbirth 88(80.7%) were preterm, less than 37weeks of gestational age. Majority of stillbirth 49(44.9%) were weighted from 1000-1499gram. Majority of stillbirth 65(59.6%) were male. Vaginal delivery occurred in 93(85.3%) and 16(14.7%) required surgical intervention. In 21(19.2%) no identifiable cause of stillbirth was found whereas causes identified in 88(80.8%). Stillbirth occurred in 27(24.8%) cases of hypertensive disorder of pregnancy and 24(22%) patients of anaemia. Other causes of stillbirth were Abruption 9(8.2%), IUGR 9(8.2%), oligohydramnios 5(4.6%) congenital malformation 3(2.8%), fever 3(2.7%), placenta previa 3(2.8%), gestational diabetes 2(1.9%), hypothyroidism 2(1.9%) and uterine rupture in 1(0.9%). DIC occurred in 4(3.6%). Conclusion: Majority of patients were unregistered and had not taken antenatal care or had inadequate antenatal care. Hypertensive disorders during pregnancy were the leading cause for stillbirth followed by anemia and unexplained causes. A significant proportion of stillbirths can be prevented by health education regarding importance of adequate antenatal care, warning signs and institutional deliveries. Emotional support and counseling of patients and her relatives are very much essential in patients having stillbirth Keywords: Stillbirth, Pregnancy.

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