European Journal of Molecular & Clinical Medicine

Aim: The aim of this study to evaluate the role of yolk sac diameter as a predictor of pregnancy outcome.
Materials and Methods: The research was conducted at the Department of Obstetrics and Gynecology, with clearance from the institute’s ethical committee. 150 pregnant women of gestational age 6-10weeks were included in this study. The trial excluded patients with molar pregnancy, ectopic pregnancy, multiple gestations, uterine anomalies, women ith known endocrine disorders.
Results: Out of total 117 cases in good outcome, 91.5% had a normal yolk sac diameter and 8.5% had an abnormal yolk sac diameter at first visit. Out of total 33 cases in poor outcome, 12.1% were found to have a normal yolk sac diameter and 87.9% were found to have an abnormal yolk sac diameter at first visit (P value <0.001). This study found that the sensitivity of normal yolk sac diameter for predicting good outcome is 91.45% and the specificity that abnormal diameter of yolk sac predicts poor outcome is 87.88%.
Conclusion: Greater yolk sac diameter had a poorer outcome compared to cases with normal yolk sac diameter, missed abortion being the most common adverse finding. Yolk sac shape and size assessment gives a good overview of pregnancy outcome in first trimester. Hence, it is advised that yolk sac biometry be done routinely in first trimester.

Background: Abortion is a major social &health issue in India. It is estimated that nearly 15 million abortions are taking place in our country every year. About 15,000 to 20,000 women die from complications arising out of legal abortions every year. Aim: The aim of the  present  study was to compare efficacy of the vaginal misoprostol alone versus extra amniotic instillation of ethacridine lactate followed by vaginal misoprostol for second trimester(13 to 20 weeks of gestation) termination of pregnancy. Materials and Methods: This study was a prospective, randomized and comparative study which was conducted in the Department of Obstetrics and Gynaecology, for a period of 1 year. A total of 53 patients were selected and divided into 2 groups. In group 1 (28 patients) vaginal misoprostol 400 mcg was inserted followed by every 4^th hourly up to maximum five doses or untill expulsion of the fetus. 25 women were allocated to group 2,  Ethacridine lactate followed by vaginal misoprostol was administered and all of them received the intervention. Results: Mean IAI in Misoprostol Alone group was 14.93 ± 2.04 hours and in Combined group was 9.72 ± 1.10 hours .The difference was significant(P<0.001). In Misoprostol group, 85.7% had complete abortion and 14.3% underwent Suction & Evacuation i/v/o retained products of conception, in Combined group, 96% had complete abortion and 4% required Suction & Evacuation i/v/o retained products of conception. The difference was not statistically significant.(P<0.201). There were  no significant side effects seen in either group. Conclusion: Combined extra amniotic instillation of ethacridine lactate followed by vaginal misoprostol  is more effective than vaginal misoprostol alone  for second trimester termination of pregnancy, resulting  in shorter induction  to abortion intervals. Use of either  method was safe with regard to side effects observed and completion of procedure.

Introduction:Unsafe abortions are a serious public health issue in India, involving the expulsion or extraction of the product of conception and causing controversy.Unmet demand exists for a simple, effective early pregnancy termination method that is both accessible and safe. Medical abortion using mifeprostone and misoprostol and surgical abortion using manual vacuum aspiration are two procedures that meet this need.
Materials and Methods:All requirements outlined in the MTP Act of 1972 by the Government of India were followed in this study. On the first day of the medical abortion, the patient was given 200 mg of mifepristone orally. After 48 hours at home, the patient was told to keep using Tab. Misoprostol 800ug vaginally.A 60ml double-valved manual vacuum aspiration syringe was used for MVA. Following the MVA syringe's attachment, the contents were aspirated. Villi on fresh tissue served as proof that the procedure was successful.The aspirated uterine contents were placed on a piece of gauze and examined to determine the gestational sac. Each woman was under observation for at least four hours following the procedure. The vital signs were examined before discharge. Inj. Women with Rh negative blood groups received 300ug of anti-D within 72 hours of the abortion.

Background: To find out the strategies for prevention of problems associated with teenage pregnancy.
Materials and Methods: A Prospective study was conducted over a period of one year from January 2020 to December 2020 at Government General Hospital, Kurnool in the Department of Obstetrics and Gynecology which is being a tertiary care centre.
Results: The incidence of teenage pregnancy during the study period from January 1 2020 – December 31 2020 in Government Medical College, Kurnool was 9.86% 57.1% of the study population were 19 yrs, 38.5% were 18 yrs and the age of 3.9% & 0.5% of the teenage mothers was 17 years and 15 years respectively. Mean age was 18.52 years. 79.5% of the teenage mothers were primigravida. 1.5% of the teenage pregnancies were out of wedlock pregnancy, the rest 98.5% were married. 43.5% of the teenage mothers were married at the age of 18 years, 39.5% of them at 17 years of age, 10.5% at 16 years and 4% and 1% at 15 and 14 years of age respectively. 71% of the teenage pregnant were residing in rural areas and 29% in urban areas. 70% of the teenage pregnant were Hindus, 26.5% were Muslims and 3.5% were Christians. About 56% had primary education, 32.4% had secondary education and 11.6% were illiterate. 87.5 % of the study population belonged to lower class of socio-economic status. Cephalopelvic disproportion is the most common indication for LSCS. 2.8% of the teenage pregnant women had breech presentation as an indication for LSCS. 89.7% of the study population had an Apgar of 8-10 at 5min. 44.1% of the newborn required NICU admission and the reason for admission was low birth weight, preterm, IUGR, hyperbilirubinemia, birth asphyxia and meconium aspiration syndrome. 89.8% of the newborn had good neonatal outcome. 99.88% of the teenage pregnant women had good maternal outcome. Only one maternal death was seen during 1 year period in teenage pregnant women.
Conclusion: Good prenatal, intranatal, and postnatal services, as well as good neonatal, contraceptive, and abortion choices, all contribute to reduce the dangers associated with teenage pregnancies to a considerable extent. With all of these measures in place, we may expect a global drop in teen pregnancy rates and difficulties in the next years.