Aim and scope: SJ Gynecology and Obstetrics Africa is an international, peer-reviewed, open-access journal published in online (ISSN: 3006-5143) and print (ISSN: 3006-5135) formats and indexed in Embase. The journal publishes original scholarly work across all areas of basic, translational, and clinical research in obstetrics, gynecology, and related disciplines. The journal considers original research articles, systematic and narrative reviews, case reports, and letters to the editor that contribute to scientific understanding and clinical practice in women’s health. Topics of interest include, but are not limited to, maternal health, reproductive health, gynecologic oncology, infertility, family planning, adolescent health, and public health aspects of obstetrics and gynecology. SJ Gynecology and Obstetrics Africa encourages submissions from researchers at all academic levels, including students, provided that manuscripts demonstrate methodological rigor, ethical approval where applicable, and scholarly relevance. The Journal was established on Sunday, 31 December 2023 and it is Published by SJC Publishers Company Limited.
A comparative study of maternal and fetal outcomes in women with gestational diabetes mellitus and overt diabetes mellitus diagnosed during pregnancy: a prospective observational comparative study.
Objectives To compare maternal, obstetric and neonatal outcomes among women with gestational diabetes mellitus and overt diabetes mellitus diagnosed during pregnancy. Methods A prospective observational comparative study was conducted among 100 pregnant women diagnosed with diabetes during pregnancy at a tertiary care hospital. Participants were categorized into two groups: 50 women with gestational diabetes mellitus and 50 women with overt diabetes mellitus. Detailed demographic, clinical, obstetric and glycaemic assessments were performed. Results The mean maternal age was higher among women with overt diabetes mellitus than those with gestational diabetes mellitus (30.62 ± 4.56 vs. 28.74 ± 4.21 years; p=0.036). The mean gestational age at diagnosis was significantly lower in the overt diabetes group (15.82 ± 4.71 vs. 25.16 ± 3.84 weeks; p<0.001). Fasting blood glucose, postprandial blood glucose and HbA1c were significantly higher among women with overt diabetes (p<0.001 for all). Insulin therapy was required more frequently in the overt diabetes group (82.0% vs. 36.0%; p<0.001). Preeclampsia occurred in 22.0% of women with overt diabetes compared with 8.0% with GDM (p=0.048). Caesarean delivery was also more frequent in overt diabetes (72.0% vs. 52.0%; p=0.039). Mean birth weight was higher in the overt diabetes group (3.38 ± 0.61 vs. 3.08 ± 0.48 kg; p=0.008). Neonatal hypoglycaemia (34.0% vs. 14.0%; p=0.024) and NICU admission (26.0% vs. 10.0%; p=0.043) were significantly more frequent among neonates born to women with overt diabetes. Conclusion Overt diabetes mellitus diagnosed during pregnancy was associated with a greater burden of maternal, obstetric and neonatal complications compared with gestational diabetes mellitus. Early diagnosis, intensive glycaemic monitoring and appropriate antenatal and intrapartum management are important for improving pregnancy outcomes. Recommendations Early screening for hyperglycaemia, appropriate differentiation of GDM from overt diabetes, individualized glycaemic management and close maternal and fetal surveillance should be emphasized.
Copyright (c) 2026 Dr. Keerti Shivaputrappa, Dr. Sonia H, Dr. Swetha K. M (Author) https://creativecommons.org/licenses/by/4.0
Effect of a 5% lidocaine patch for postoperative pain relief following cesarean section: a randomized double-blind placebo-controlled trial.
Introduction Effective postoperative analgesia after cesarean section supports early mobilization, maternal-infant interaction, breastfeeding, and recovery. This study evaluated the analgesic efficacy and safety of a 5% lidocaine patch after cesarean delivery. Materials and Methods In this prospective, randomized, double-blind, placebo-controlled trial, 120 women undergoing cesarean section under spinal anesthesia were allocated 1:1 to a 5% lidocaine patch (n=60) or an identical placebo patch (n=60). Pain was assessed on a 0-10 numerical rating scale at 0, 2, 4, 6, 8, 12, and 24 hours. Rescue analgesic use, ambulation, satisfaction, hemodynamic variables, and adverse effects were evaluated. Results Baseline characteristics were comparable. Mean age was 28.7 ± 3.9 years in the lidocaine group and 29.1 ± 4.2 years in controls; mean BMI was 25.1 ± 2.8 and 25.4 ± 3.0 kg/m², respectively, and mean gestational age was 38.4 ± 0.9 and 38.3 ± 1.0 weeks. ASA I status was present in 63.3% and 60.0%, respectively. At 24 hours, pain was lower with lidocaine (2.1 ± 0.7 vs. 2.8 ± 0.9; mean difference -0.70, 95% CI -0.99 to -0.41; p<0.001). Time to first rescue analgesia was longer (8.4 ± 2.1 vs. 5.9 ± 1.8 hours; mean difference 2.50 hours, 95% CI 1.79 to 3.21), and total rescue analgesic consumption was lower (82.5 ± 34.7 vs. 121.7 ± 42.6 mg; mean difference -39.20 mg, 95% CI -53.25 to -25.15; both p<0.001). Ambulation occurred earlier and satisfaction was higher, while overall adverse effects were comparable. Conclusion A 5% lidocaine patch improved early postoperative analgesia and reduced rescue analgesic requirements without evidence of increased adverse effects. Recommendation The patch can be considered as an adjunct to multimodal post-cesarean analgesia, while larger multicenter trials should confirm effectiveness, safety, and optimal application protocols.
Copyright (c) 2026 Dr. Chandrashekar B, Dr . Anup Nisti, Dr. Praveen Kumar DP (Author) https://creativecommons.org/licenses/by/4.0
Influence of uterine fibroids on the intrapartum maternal outcome: A retrospective study.
Introduction Uterine fibroids are common benign uterine tumours in women of reproductive age and can complicate labour through mechanical obstruction, altered uterine contractility, malpresentation, and postpartum haemorrhage. Their intrapartum influence varies according to fibroid size and anatomical location. Materials and Methods This hospital-based retrospective observational study included 120 pregnant women with documented uterine fibroids who delivered at a tertiary care teaching hospital in Bengaluru, India. Demographic, obstetric, ultrasonographic, intrapartum, and postpartum information was retrieved from hospital records. Fibroid number, size, location, lower uterine segment involvement, mode of delivery, caesarean indications, labour complications, postpartum haemorrhage, uterine atony, and transfusion requirement were assessed. Categorical associations were evaluated using appropriate tests, with p<0.05 considered statistically significant. Results Of the 120 women, 35.0% were aged 30–34 years, 30.8% were aged 25–29 years, and 19.2% were aged ≥35 years; 60.0% were multigravidas. Most delivered at 37–40 weeks (75.8%), and 88.3% had cephalic presentation. Caesarean delivery occurred in 58.3%, whereas 41.7% had vaginal delivery. Intramural fibroids were most frequent (51.7%), and 48.3% had fibroids <5 cm. Caesarean delivery increased with fibroid size: 50.0% for <5 cm, 61.2% for 5–10 cm, and 84.6% for >10 cm (p=0.027). Lower uterine segment involvement was associated with a higher caesarean rate (81.8% vs 53.1%; p=0.014). Labour dystocia occurred in 17.5%, postpartum haemorrhage in 13.3%, uterine atony in 10.8%, and blood transfusion in 7.5%. Conclusion Larger fibroids and lower uterine segment involvement were associated with increased caesarean delivery and clinically important maternal complications. Recommendations Antenatal assessment of fibroid size and location, individualized delivery planning, and preparedness for haemorrhagic complications are recommended.
Copyright (c) 2026 Dr. Sonia H, Dr. Swetha K. M, Dr. Keerti Shivaputrappa (Author) https://creativecommons.org/licenses/by/4.0
Comparative study of maternal and neonatal outcome of 1st stage and 2nd stage caesarean sections in a tertiary centre.
Introduction Caesarean delivery during the second stage of labour is technically more difficult because of deep fetal head engagement and prolonged labour, potentially increasing maternal and neonatal morbidity. Materials and Methods This hospital-based retrospective observational study included 120 women undergoing intrapartum caesarean section at a tertiary care centre, with 60 first-stage and 60 second-stage procedures. Demographic, obstetric, operative, maternal, and neonatal outcomes were extracted from hospital records. Group comparisons used independent-samples t-tests for continuous variables and chi-square tests for categorical variables, with p<0.05 considered significant. Results Maternal age was comparable between first-stage and second-stage groups (25.87 ± 3.42 vs. 26.43 ± 3.71 years; p=0.387). Second-stage caesarean sections were associated with longer labour (10.64 ± 2.87 vs. 7.82 ± 2.31 hours; p<0.001) and longer second-stage duration (89.27 ± 31.54 vs. 36.42 ± 18.61 minutes; p<0.001). Uterine incision extension (21.7% vs. 5.0%; p=0.008), difficult fetal head delivery (30.0% vs. 3.3%; p<0.001), and atonic postpartum haemorrhage (18.3% vs. 6.7%; p=0.044) were more frequent in the second-stage group. Operative duration (61.82 ± 14.71 vs. 48.63 ± 10.24 minutes; p<0.001) and estimated blood loss (781.83 ± 211.46 vs. 612.50 ± 143.72 mL; p<0.001) were also greater. Mean 1-minute and 5-minute Apgar scores were lower (6.93 ± 1.12 vs. 7.52 ± 0.86; p=0.002 and 8.19 ± 0.91 vs. 8.71 ± 0.62; p<0.001), while neonatal resuscitation (25.0% vs. 8.3%; p=0.013) and NICU admission (26.7% vs. 10.0%; p=0.017) were higher after second-stage caesarean section. Conclusion Second-stage caesarean section was associated with greater maternal operative morbidity and less favourable early neonatal outcomes than first-stage caesarean section. Recommendations Timely intrapartum decision-making and preparedness for difficult fetal extraction, haemorrhage, and neonatal resuscitation are essential when second-stage caesarean delivery is anticipated.
Copyright (c) 2026 Dr. Swetha K. M., Dr. Sonia H, Dr. Keerti Shivaputrappa (Author) https://creativecommons.org/licenses/by/4.0
Maternal and fetal outcomes of labour in pregnancies with cardiac disease: a prospective observational study.
Objectives To evaluate maternal and fetal outcomes of labour among pregnant women with cardiac disease and assess obstetric and cardiac complications during labour and the postpartum period Methods A prospective observational study was conducted among 50 pregnant women with cardiac disease admitted in labour at a tertiary care hospital in Karnataka, India. Participants underwent clinical, obstetric and cardiovascular assessment, including electrocardiography and two-dimensional echocardiography. Maternal cardiac and obstetric complications, mode of delivery, maternal outcomes and neonatal outcomes were recorded prospectively until discharge. Results Most women were aged 21–30 years (44, 88.0%), and 43 (86.0%) were in NYHA functional class I. Rheumatic heart disease was the commonest cardiac lesion (23, 46.0%), followed by congenital heart disease (14, 28.0%); mitral stenosis predominated among rheumatic lesions (19, 82.6%). Cardiac complications occurred in 2 (4.0%) women, comprising congestive cardiac failure and arrhythmia. Vaginal delivery was the commonest mode (24, 48.0%), followed by LSCS (15, 30.0%) and instrumental delivery (11, 22.0%). Preeclampsia (9, 18.0%) and intrauterine growth restriction (7, 14.0%) were the commonest obstetric complications. Maternal outcome was uneventful in 36 (72.0%), while 14 (28.0%) required HDU care. Among 51 newborns, 18 (35.3%) had birth weight <2.5 kg. There were 47 (94.0%) live births and 3 (6.0%) intrauterine deaths. NICU admission occurred in 12 (24.0%) and prematurity in 10 (20.0%) pregnancies. Conclusion Outcomes were generally favourable, but cardiac complications and adverse perinatal outcomes occurred, emphasizing risk stratification, individualized delivery planning and multidisciplinary maternal-fetal surveillance. Recommendations Early identification and risk stratification of pregnant women with cardiac disease should be emphasized. Individualized delivery planning, close maternal and fetal monitoring during labour and postpartum surveillance are recommended, particularly in high-risk women managed at centres with appropriate cardiac, obstetric, anaesthetic and neonatal facilities.
Copyright (c) 2026 Dr. Keerti Shivaputrappa, Dr. Swetha K. M, Dr. Sonia H (Author) https://creativecommons.org/licenses/by/4.0
Role of saline infusion sonohysterography in abnormal uterine bleeding: a hospital-based observational study.
Introduction Abnormal uterine bleeding is a common gynaecological complaint, particularly among perimenopausal and postmenopausal women. Focal intracavitary lesions such as endometrial polyps and submucosal fibroids may be difficult to characterize on transvaginal sonography. Saline infusion sonohysterography improves delineation of the endometrial cavity and may enhance diagnostic assessment. Materials and Methods A hospital-based observational study was conducted among 50 perimenopausal and postmenopausal women presenting with abnormal uterine bleeding. Participants underwent clinical evaluation, transvaginal sonography and saline infusion sonohysterography. Women with suspected intracavitary lesions or increased endometrial thickness underwent appropriate definitive procedures, including dilatation and curettage, hysteroscopy-guided biopsy or polypectomy, or hysterectomy. Histopathological examination was used as the reference standard. Results Among 50 women, 33 (66.0%) were perimenopausal and 17 (34.0%) were postmenopausal, with a mean age of 49.9 ± 9.08 years. Menorrhagia was the most common symptom (48.0%). Transvaginal sonography showed polypoidal thickening in 26 (52.0%), while saline infusion sonohysterography identified endometrial polyps in 31 (62.0%) and submucous fibroids in 8 (16.0%). Histopathology demonstrated endometrial polyps in 31 (62.0%), endometrial hyperplasia in 10 (20.0%), fibroid uterus in 5 (10.0%), and normal endometrium in 4 (8.0%). The association between saline infusion sonohysterography and histopathological diagnosis was significant (p<0.001). Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 83.0%, 100.0%, 100.0%, 27.27% and 84.0%, respectively. Conclusion Saline infusion sonohysterography demonstrated good diagnostic performance for intracavitary lesions in women with abnormal uterine bleeding and is a useful complementary investigation following transvaginal sonography. Recommendations Saline infusion sonohysterography should be considered when transvaginal sonography demonstrates endometrial thickening or suspected intracavitary pathology.
Copyright (c) 2026 Dr. Swetha K. M., Dr. Keerti Shivaputrappa, Dr. Sonia H (Author) https://creativecommons.org/licenses/by/4.0
Reproductive morbidity and associated factors among ever-married women aged 15–49 years attending a tertiary care hospital in bihar: a hospital-based observational study.
Background Reproductive morbidity remains an important public health concern among women of reproductive age, particularly in rural and socioeconomically disadvantaged populations. Identifying common reproductive morbidities and their associated factors is essential for improving women's reproductive health. Aim To determine the prevalence and pattern of reproductive morbidity among ever-married women aged 15–49 years attending Madhubani Medical College and Hospital and to identify associated socio-demographic and reproductive factors. Materials and Methods A hospital-based observational study was conducted among 120 ever-married women aged 15–49 years attending the Gynecology Outpatient Department. Participants were enrolled using consecutive sampling. Socio-demographic characteristics, menstrual and reproductive history, contraceptive practices, menstrual hygiene, clinical findings, and relevant investigations were recorded using a structured proforma. Data were analysed using SPSS version 27.0. Associations were assessed using the Chi-square test or Fisher's exact test, as appropriate, and multivariable logistic regression was performed to identify independent predictors. Results The mean age of participants was 31.8 ± 7.4 years. Overall, 72 (60.0%) women had at least one reproductive morbidity. Reproductive tract infections were the most common morbidity (31.7%), followed by menstrual disorders (24.2%), pelvic inflammatory disease (16.7%), cervical erosion (15.0%), uterine fibroids (12.5%), ovarian cysts (10.8%), and pelvic organ prolapse (8.3%). Increasing age, multiparity, poor menstrual hygiene, and low educational status were significantly associated with reproductive morbidity (p<0.05). On multivariable analysis, poor menstrual hygiene, multiparity, low educational status, and age ≥35 years were independent predictors. Conclusion Reproductive morbidity was common among ever-married women attending the tertiary-care hospital. Strengthening reproductive health screening, menstrual hygiene education, health awareness, and timely diagnosis and management may help reduce the burden of reproductive morbidity.
Copyright (c) 2026 Dr. Dipesh Kumar Gupta (Author) https://creativecommons.org/licenses/by/4.0
Is IOTA simple rules superior to RMI 1 for ovarian tumor diagnosis? A systematic review.
Background Accurate preoperative discrimination between benign and malignant ovarian or adnexal masses is essential for appropriate surgical planning and referral. The Risk of Malignancy Index 1 (RMI 1) incorporates ultrasound findings, menopausal status, and serum CA125, whereas the International Ovarian Tumor Analysis (IOTA) Simple Rules provide an ultrasound-based classification without requiring CA125. This systematic review evaluated whether IOTA Simple Rules perform better than RMI 1 in distinguishing benign from malignant ovarian masses. Methods MEDLINE/PubMed, Embase, Cochrane Library, and Web of Science were searched from database inception to April 2026 for studies directly applying both IOTA Simple Rules and RMI 1 to the same patients, using histopathology as the reference standard. Eligible studies were assessed for methodological quality using QUADAS-2. Because only a small number of heterogeneous studies met the strict head-to-head eligibility criteria, findings were synthesised narratively rather than by quantitative meta-analysis. Results Three studies involving 804 women met the inclusion criteria. IOTA Simple Rules demonstrated sensitivity ranging from 83.8% to 88.9%, compared with 45.5% to 77.2% for RMI 1. Specificity ranged from 92.0% to 94.1% for IOTA Simple Rules and from 86.8% to 93.2% for RMI 1. IOTA Simple Rules were inconclusive in approximately 14–18% of masses in studies reporting this outcome. Conclusions The available direct evidence suggests that IOTA Simple Rules perform at least as well as, and generally better than, RMI 1, particularly for sensitivity. However, the evidence is limited by the small number of eligible studies and substantial heterogeneity. IOTA Simple Rules also have the practical advantage of not requiring CA125 testing. Need for future research Larger, prospective, standardised head-to-head studies across diverse populations are required before IOTA Simple Rules can be considered a definitive replacement for RMI 1.
International Ovarian Tumor Analysis Simple Rules
Copyright (c) 2026 Ruby Kumari, Shaesta Iqbal, Sweta Gupta, Vijya (Author) https://creativecommons.org/licenses/by/4.0
Diagnostic Dilemma: Large Primary Ovarian Leiomyoma Imitating Fibroma in a Postmenopausal Patient: Case Report
Primary ovarian leiomyoma is extremely uncommon, with a low incidence rate of 0.5-1% of benign ovarian tumors. Due to its rarity, it poses a diagnostic dilemma and needs to be differentiated from other spindle cell neoplasms of the ovary. We report a case of a large symptomatic primary ovarian leiomyoma in a postmenopausal woman, which was misdiagnosed as fibroma of the ovary both clinically and radiologically. Microscopy revealed a spindle cell tumor arranged in short intersecting fascicles, which were positive for SMA and h-caldesmon on immunohistochemistry. is a useful adjunct for definitive diagnosis and confirming smooth muscle origin. While malignant solid ovarian tumors are much more common, the consideration of ovarian leiomyoma as a differential diagnosis of solid ovarian tumors is essential, as the treatment modality is surgical resection. Diagnosing ovarian leiomyoma before and during surgery is challenging. It is advisable to perform both histopathological examination and immunohistochemical analysis.
Copyright (c) 2026 Dr. Ruchi Sinha, Dr Preetika Sinha, Dr. Tarun Kumar, Dr. Avinash Singh, Dr. Shankhanila Mazumdar (Author) https://creativecommons.org/licenses/by/4.0
Predictive Value of First-Trimester Uterine Artery Doppler in the Development of Preeclampsia and Intrauterine Growth Restriction: A Prospective Observational Study.
Background: Preeclampsia and intrauterine growth restriction (IUGR) are important causes of maternal and perinatal morbidity. Early identification of women at increased risk may allow closer surveillance and timely intervention. This study evaluated the predictive value of first-trimester uterine artery Doppler for preeclampsia and IUGR. Methods: This prospective observational study included 120 pregnant women attending Sheikh Bhikhari Medical College and Hospital, Hazaribagh, between July 2025 and June 2026. Uterine artery Doppler ultrasonography was performed at 11+0 to 13+6 weeks of gestation. Mean uterine artery pulsatility index (UtA PI) and early diastolic notching were recorded. Participants were followed until delivery. The associations between abnormal Doppler findings and pregnancy outcomes were assessed, and predictive performance was evaluated using diagnostic measures and receiver operating characteristic (ROC) curve analysis. Results: Abnormal first-trimester uterine artery Doppler findings were observed in 29 (24.2%) women. Preeclampsia developed in 18 (15.0%) and IUGR in 15 (12.5%). Abnormal Doppler findings were significantly associated with preeclampsia (41.4% vs. 6.6%; p<0.001) and IUGR (34.5% vs. 5.5%; p<0.001). For predicting preeclampsia, Doppler demonstrated 66.7% sensitivity, 83.3% specificity, 41.4% positive predictive value, 93.4% negative predictive value, and 80.8% diagnostic accuracy. For IUGR, the corresponding values were 66.7%, 81.9%, 34.5%, 94.5%, and 80.0%, respectively. ROC analysis showed good predictive performance for preeclampsia (AUC 0.84) and IUGR (AUC 0.81). Abnormal Doppler findings were also associated with lower birth weight, earlier delivery, increased preterm birth, and NICU admission. Conclusion: First-trimester uterine artery Doppler may be a useful non-invasive screening tool for identifying pregnancies at increased risk of preeclampsia and IUGR, particularly where biochemical screening is unavailable. Recommendation: Incorporation of first-trimester uterine artery Doppler into antenatal risk assessment may facilitate early identification of high-risk pregnancies and enable closer surveillance and timely preventive management.
Health facility factors influencing the waiting time among pregnant mothers attending antenatal clinic at Kira Health Centre IV, Wakiso District. A cross-sectional study.
Background: This study aimed to assess health facility factors influencing waiting time among pregnant mothers attending antenatal clinic at Kira Health Centre IV, Wakiso District. Methodology: A descriptive cross-sectional study using quantitative data collection methods was conducted among pregnant mothers attending antenatal care at Kira Health Centre IV. 80 respondents were selected using simple random sampling, and data were collected using interviewer-administered structured questionnaires. Data were coded, entered and analysed in Microsoft Excel. Results were presented using frequencies, percentages, tables, graphs and charts. Results: 34(42.5%) of the respondents were aged 18 – 25 years, while 4(5%) were aged above 45 years. The majority of the respondents, 51(63.7%), had attained secondary education; 7(8.8%) had never gone to school, 59(73.8%), were married, while 2(2.5%), were divorced. 42(52.5%), were unemployed; 3(3.8%), belonged to public employment. 36(45%), were Catholics; 2(2.5%), were Seventh-day Adventists. 40(50%) respondents spent 1–2 hours at the registration desk while obtaining their antenatal cards, whereas only 7(8.8%) spent less than 30 minutes. 44(55%) reported that health workers never communicated about the flow of services. 58(72.5%) reported that signposts or arrows were present in some departments, while 9(11.2%) reported that none were present. 48(60%) perceived the speed of health workers as slow, and 68 (85%) reported that the antenatal clinic was understaffed. Conclusion: Delays at registration, inadequate communication about service flow, limited directional signage, slow movement of health workers, and understaffing were the major health-facility factors associated with prolonged waiting times. Recommendation: More health workers should be recruited, directional signs should be installed in all departments, and health workers should improve communication about service flow and timely delivery of antenatal services.
Copyright (c) 2026 Shifa Mugide, Patrick Ssendugga, Grace Denise Akwang, Suzan Oyesigye, Jacob Usuo Kibuuka (Author) https://creativecommons.org/licenses/by/4.0
Association of maternal hypertensive disorders of pregnancy with neonatal morbidity and NICU admission: A two-year retrospective observational study from a tertiary care Centre in Eastern India.
Background: Hypertensive disorders of pregnancy (HDP), particularly pre-eclampsia and eclampsia, are major contributors to maternal and neonatal morbidity and are associated with adverse neonatal outcomes, including prematurity, low birth weight, and neonatal intensive care unit (NICU) admission. Objective: To determine the incidence of pre-eclampsia/eclampsia among deliveries at a tertiary care teaching hospital and evaluate its association with neonatal morbidity and NICU admission compared with normotensive pregnancies. Methods: This retrospective observational cohort study was conducted in the Department of Obstetrics and Gynaecology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, using departmental records from January 2024 to December 2025. Women diagnosed with pre-eclampsia/eclampsia after 20 weeks of gestation and delivering at ≥28 weeks were included. Neonatal outcomes were compared with those of normotensive pregnancies using the chi-square test and relative risk (RR), with p<0.05 considered statistically significant. Results: Among 1,378 deliveries, 83 (6.02%) were complicated by pre-eclampsia/eclampsia. Compared with normotensive pregnancies, neonates of mothers with hypertensive disorders had significantly higher rates of NICU admission (71.1% vs. 7.6%; RR=9.39, p<0.001), preterm birth (31.3% vs. 17.1%; RR=1.84, p=0.002), low birth weight (55.4% vs. 29.7%; RR=1.87, p<0.001), stillbirth/intrauterine death (9.6% vs. 1.7%; RR=5.67, p<0.001), respiratory distress (28.9% vs. 3.7%; RR=7.80, p<0.001), and meconium aspiration (14.5% vs. 2.0%; RR=7.20, p<0.001). Conclusion: Maternal hypertensive disorders of pregnancy are significantly associated with adverse neonatal outcomes and substantially increased NICU admission. Recommendation: Early antenatal detection, close maternal–fetal surveillance, and timely referral of high-risk pregnancies to tertiary centres with NICU facilities are recommended to improve neonatal outcomes.
Copyright (c) 2026 Dr. Supriya Kumari, Dr. Amrita Bharti, Dr. Archana Singh (Author) https://creativecommons.org/licenses/by/4.0
Prevalence and clinical correlates of impaired glucose tolerance in young women with polycystic ovary syndrome.
Background: PCOS is often accompanied by insulin resistance, even during adolescence and early adulthood. Fasting glucose may remain normal despite abnormal glucose handling after a glucose load. This study estimated the prevalence of IGT and diabetes mellitus in young women with PCOS and examined their demographic, anthropometric, familial, and clinical correlates. Methods: A hospital-based cross-sectional study was conducted in the Departments of OBG at Kakatiya Medical College, Hanumakonda, and Government Medical College, Mulugu, Telangana, India. The study included 100 women aged 15–25 years who fulfilled the Rotterdam criteria for PCOS. Disorders that could mimic PCOS were excluded. Demographic characteristics, anthropometric measurements, family history, and clinical findings were recorded. Glycaemic status was assessed using a 75 g oral glucose tolerance test and classified according to WHO criteria. Associations were tested using the chi-square or Fisher’s exact test. Results: Abnormal glucose tolerance was identified in 27% of participants. IGT was present in 22%, while 5% had diabetes mellitus; the remaining 73% had normal glucose tolerance. Dysglycaemia was observed across the 15–25-year age group and was proportionally higher among women from urban areas, higher socioeconomic groups, and those with a family history of PCOS, although these demographic associations were not statistically significant. The prevalence of abnormal glucose tolerance increased with BMI and was highest among women with class II obesity. A waist–hip ratio of ≥0.85 and a family history of diabetes were also significantly associated with dysglycaemia. Acanthosis nigricans, primary subfertility, and polycystic ovarian morphology on ultrasonography were more frequent among women with IGT or diabetes. Conclusion: More than one in four young women with PCOS had abnormal glucose tolerance. A 75 g oral glucose tolerance test may help identify early dysglycaemia, particularly in women with obesity, central adiposity, acanthosis nigricans, or a family history of diabetes.
Copyright (c) 2026 Swetha Reddy Sambireddy, Laxmi Malladi, Rahulya Marapelly (Author) https://creativecommons.org/licenses/by/4.0
Efficacy, side-effect profile, and continuation of depot medroxyprogesterone acetate as a spacing contraceptive: a prospective hospital-based observational cohort study.
Objective: To evaluate the contraceptive efficacy, side-effect profile, acceptance, and continuation of intramuscular depot medroxyprogesterone acetate among women choosing temporary contraception. Methods: This prospective, hospital-based observational cohort study was conducted in the Department of Obstetrics and Gynaecology at CKM Government Maternity Hospital, Warangal. Eligible postpartum, post-abortal, and interval clients who selected depot medroxyprogesterone acetate after counselling were enrolled consecutively during a 2-month recruitment period. One hundred women received 150 mg intramuscular depot medroxyprogesterone acetate and were followed for repeat injections, side effects, attrition, and pregnancy. Frequencies, percentages, and chi-square tests were used. Results: Most women were aged 21-25 years (62.0%), followed by 26-30 years (29.0%). Primigravida women formed the largest group (58.0%). DMPA was initiated most often in the postpartum period (53.0%), followed by post-abortal (30.0%) and interval initiation (17.0%). Follow-up declined progressively, with 42.0% returning after the first injection, 29.0% after the second, 18.0% after the third, and 11.0% after the fourth. Irregular bleeding was the most commonly reported side effect (48.0%), followed by amenorrhea (30.0%), weight gain (8.0%), and headache (3.0%). Side effects were the leading reason for attrition (47.0%). No pregnancy was recorded during the study follow-up, giving an observed Pearl Index of zero in this cohort. Age group was significantly associated with timing of injection (chi-square 18.86, p=0.004), while age-wise differences in specific side effects and attrition reasons were not statistically significant. Conclusion: Depot medroxyprogesterone acetate showed complete observed contraceptive efficacy in this cohort, but continuation decreased with successive injections. Menstrual changes, particularly irregular bleeding and amenorrhea, were the main tolerability concerns and contributed substantially to attrition.
Copyright (c) 2026 Vidya Rani Dasari, Swetha Reddy Sambireddy, Laxmi Malladi (Author) https://creativecommons.org/licenses/by/4.0
Analysis of missing data and completeness modeling of cancer clinical records: The case of the Ngaliema Clinic in Kinshasa, Democratic Republic of Congo
Introduction The present study aims to examine the completeness and model the exhaustiveness of clinical records of cancer patients followed at the Ngaliema Clinic in Kinshasa. Materials and methods A retrospective study analyzed the records of 81 patients with cancer followed at the Ngaliema clinic between 2023 and 2025. Using JASP 0.95.4.0 software, descriptive and inferential analyses based on the Little, Friedman, Durbin -Conover test and a multiple linear regression model were performed at the usual threshold of 0.05. Results There was a predominance of women and patients under 50 years of age, mostly residing in the Lukunga district, with cancer diagnosed at an invasive stage (stage II) among the patients whose records were analyzed. The MCAR hypothesis was verified (p = 0.767). A significant difference was observed between the five evaluated recording domains ( χ² = 135; p < 0.001). Furthermore, the overall completeness score decreases significantly according to age (β = -0.174; p = 0.016); bilateral organ involvement (β = -7.349; p = 0.029); year of detection 2024 vs 2025 (β = -10.732; p < 0.001); non-invasive nature of the disease (β = -5.893; p = 0.047); family history of cancer (β = -4.491; p = 0.028); of residence in the Funa district vs. Lukunga (β = -4.547; p = 0.017) and of initial traditional treatment/prayer (β = -5.822 ; p = 0.025). However, this score increases with the time elapsed before consultation (β = 0.476 ; p < 0.001) and then with origin from the Tshangu district (β = 9.236 ; p = 0.009). Conclusion The completeness of cancer records at the Ngaliema Clinic depends markedly on clinical severity, patient age, and therapeutic pathway. Recommendation Implement a standardized oncology form, strengthen digital skills, support digitization and develop a sustainable provincial cancer registry.
Copyright (c) 2026 Pascal Mamenepi Atuba, Héritier Belangana Kalubi, Jean-Pierre Olonge Omokende, Crispin Katombe Kakwaka, Jacques Masumbuku Lofandjola, Félicien Ilunga Ilunga, Félicien Kandolo Tshimungu (Author) https://creativecommons.org/licenses/by/4.0
Clinicopathological profile of endometrial carcinoma in postmenopausal women: A hospital-based cross-sectional study.
Background Endometrial carcinoma is among the most common gynecological malignancies in postmenopausal women and requires early diagnosis for improved outcomes. Objective: To evaluate the clinicopathological profile of endometrial carcinoma in postmenopausal women attending a tertiary care hospital. Methods This hospital-based cross-sectional study included 100 postmenopausal women with histopathologically confirmed endometrial carcinoma. Clinical features, histopathological findings, and FIGO stage were analyzed using SPSS version 26. The association between tumor grade and stage was assessed using the Chi-square test. Results The mean age was 61.4 ± 7.8 years, and 45% of patients belonged to the 50–60-year age group. Postmenopausal bleeding was the most common symptom (82%). Endometrioid carcinoma was the predominant subtype (78%), while 56% of patients presented in FIGO Stage I. Tumor grade showed a significant association with disease stage (χ²=28.6, p=0.001). Conclusion Endometrial carcinoma commonly presents with postmenopausal bleeding and is frequently diagnosed at an early stage. Histopathological grade is significantly associated with disease stage and prognosis. Recommendation Early evaluation of postmenopausal bleeding and prompt histopathological assessment should be encouraged to improve diagnosis and management.
Copyright (c) 2026 Dr. Bishal Datta, Dr. Prannoy Das, Dr. Bhabani Charan Das (Author) https://creativecommons.org/licenses/by/4.0
Comparative safety and efficacy of continuous versus interrupted suturing for episiotomy repair: a parallel-group randomised controlled trial.
Background Episiotomy repair technique may influence procedure time, suture consumption, acute perineal pain, and wound outcomes. Objective To compare the safety and efficacy of continuous and interrupted suturing techniques for mediolateral episiotomy repair. Methods This parallel-group randomised controlled trial included 204 primigravid women undergoing right mediolateral episiotomy. Participants were allocated 1:1 to continuous non-locking repair or conventional three-layer interrupted repair (102 per group). Both groups received fast-absorbing polyglactin 910, diclofenac 75 mg intramuscularly, and identical postnatal care. Primary outcomes were VAS pain scores at 12 and 24 hours; secondary outcomes included repair time, suture use, later pain, rescue analgesia, and wound status. Results All 204 participants received the allocated repair and completed follow-up. Continuous suturing used less suture material (75 versus 90 cm) and required less time (14 versus 17 minutes; p=0.0004 for both). Pain was lower at 12 and 24 hours (p=0.0004 for both) but comparable at 3 and 6 weeks. Rescue analgesia was required by 2.0% and 7.8% of women, respectively (p=0.101). Wound status was comparable (exact p=0.248). Conclusion Continuous suturing was associated with shorter repair time, lower suture consumption, and less early perineal pain, without a significant difference in rescue analgesia or short-term wound status. Recommendation Continuous suturing may be considered for episiotomy repair when clinicians are appropriately trained; larger, rigorously reported multicentre trials with longer follow-up are recommended.
Copyright (c) 2026 Dr . Raghvendra Mahilange, Dr. Lavanya Anuranjani (Author) https://creativecommons.org/licenses/by/4.0
A study on obstetric management in term pregnancies infected with SARS-COV-2 and fetomaternal outcomes.
Background Pregnant women with SARS-CoV-2 infection may be at increased risk of adverse maternal and neonatal outcomes because of physiological and immunological changes during pregnancy. This study aimed to evaluate the obstetric management, maternal outcomes, and neonatal outcomes in term pregnancies complicated by COVID-19 infection. Materials and Methods A retrospective observational cohort study was conducted among 200 term pregnant women with laboratory-confirmed COVID-19 admitted to a tertiary care hospital between June 2020 and May 2021. Maternal clinical profile, laboratory parameters, mode of delivery, maternal complications, and neonatal outcomes were analyzed from hospital records. Results The mean maternal age was 25.6 ± 3.94 years. Most women were asymptomatic (78%), while cough was the most common presenting symptom among symptomatic women. Common comorbidities included anemia (3%), hypertensive disorders (12%), and hypothyroidism (5.5%). Spontaneous labour occurred in 41.5% of women, while 50% underwent cesarean delivery. Five women (2.5%) required intensive care admission, and two maternal deaths occurred due to acute respiratory distress syndrome. Mean gestational age at delivery was 38.47 ± 0.83 weeks, and mean birth weight was 2810 ± 431 g. Two neonates (1%) tested positive for SARS-CoV-2 and remained clinically stable. One intrauterine death, one stillbirth, and one neonatal death were reported. Conclusion Most pregnant women with COVID-19 had mild disease and favorable maternal and neonatal outcomes. Severe maternal morbidity and mortality were more common in women with associated comorbidities. Recommendation Early identification of high-risk pregnant women with COVID-19 and close multidisciplinary monitoring may help reduce adverse fetomaternal outcomes.
Copyright (c) 2026 Dr .Sindhukavi P, Dr. Parvathananeni Divya, Dr .Sornalatha.C.L, Dr .Ramnivas R4 (Author) https://creativecommons.org/licenses/by/4.0
Antenatal ultrasound assessment of the umbilical coiling index as an imaging marker of adverse perinatal outcomes: a hospital-based prospective observational cohort study.
Background The helical arrangement of umbilical vessels protects fetoplacental circulation by providing resistance to compression and torsion. Abnormal umbilical coiling patterns have been associated with adverse perinatal outcomes. This study evaluated the role of the Umbilical Coiling Index (UCI) as an antenatal imaging marker of fetal compromise. Methods This hospital-based prospective observational cohort study included 181 singleton pregnancies beyond 28 weeks of gestation conducted at Karpagam Institute of Medical Sciences and Research, Coimbatore, India, between May 2023 and May 2025. Based on antenatal UCI assessment, pregnancies were categorized as normocoiled (n=95), hypocoiled (n=53), and hypercoiled (n=33). Maternal, intrapartum, and neonatal outcomes were compared among the groups. Results Hypocoiled cords showed significantly higher rates of preterm labour (38%, p=0.006), fetal heart rate deceleration (45%, p=0.001), and low 5-minute Apgar scores (13%, p=0.036) compared with normocoiled and hypercoiled cords. The hypocoiled group also demonstrated the lowest mean cord pH (7.074), indicating a trend toward fetal acidosis, although this was not statistically significant (p=0.067). Meconium-stained liquor was more frequent in hypercoiled cords but did not differ significantly among groups (p=0.687). Conclusion The antenatal Umbilical Coiling Index is a simple and reproducible sonographic biomarker that may improve risk stratification during routine obstetric ultrasound, particularly for identifying fetuses at risk of intrapartum compromise and adverse neonatal outcomes. Recommendation Routine incorporation of UCI assessment into structured obstetric ultrasound reporting.
Copyright (c) 2026 Dr. M. Deyananda Chakravarthy, Dr. Valarmathi, Dr. Divyapriya S (Author) https://creativecommons.org/licenses/by/4.0
Maternal BMI and hypertensive disorders of pregnancy: A cross-sectional observational analytical study in a tertiary care centre.
Background: Maternal body mass index is a practical antenatal marker that reflects nutritional and metabolic status. Excess BMI is linked with endothelial dysfunction, insulin resistance, inflammation, and increased risk of hypertensive disorders of pregnancy. Objectives: To assess the distribution of maternal BMI and determine its association with hypertensive disorders of pregnancy among pregnant women attending a tertiary care centre. Methods: This observational analytical study was conducted at RP Hospital, Parbhani, Maharashtra, India, from September 2025 to February 2026. A total of 100 pregnant women were included. Maternal BMI was categorized as underweight, normal, overweight, and obese. Hypertensive disorders were classified as gestational hypertension, mild preeclampsia, severe preeclampsia, and eclampsia. Associations were analysed using appropriate statistical tests and logistic regression. Results: The mean maternal age was 26.8 ± 4.5 years, and the mean BMI was 25.4 ± 4.2 kg/m². Overall, 8.0% were underweight, 40.0% had normal BMI, 34.0% were overweight, and 18.0% were obese. Hypertensive disorders were present in 29.0% of participants. Their prevalence increased from 15.0% in normal BMI women to 35.3% in overweight women and 55.6% in obese women. Obesity showed a significant adjusted association with hypertensive disorders. Preterm delivery and low birth weight were also more frequent among affected women. Conclusion: Increasing maternal BMI was significantly associated with hypertensive disorders of pregnancy and selected adverse perinatal outcomes. Recommendations: Early BMI assessment, weight counselling, blood pressure surveillance, and risk-based antenatal follow-up should be integrated into routine obstetric care.
Copyright (c) 2026 Ashwini Ganeshrao Gaikwad, Jagruti Ratnakar Keskar, Deepak Ashok Kubde (Author) https://creativecommons.org/licenses/by/4.0
Fetomaternal outcomes in teenage pregnancy: A prospective observational study from a tertiary care centre in southern Odisha.
Background: Teenage pregnancy remains a major public health concern in developing countries, associated with increased maternal and neonatal morbidity and mortality. Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology, MKCG Medical College and Hospital, Berhampur, Odisha, from March 2024 to September 2025. A total of 362 pregnant adolescents aged 13–19 years were enrolled. Data on sociodemographic profile, obstetric complications, mode of delivery, and neonatal outcomes were collected and analysed. Results: The incidence of teenage pregnancy was 2.82 per 12,800 obstetric admissions. Most participants were aged 18–19 years (85.36%), from rural areas (70.16%), and unbooked (84.53%). Anemia (77.90%) was the most common complication, followed by hypertensive disorders (19.06%) and preterm labour (25.97%). Vaginal delivery occurred in 60.22%, while lower segment caesarean section (LSCS) was performed in 30.94%. Among 314 live births, 30.25% were low birth weight, 35.35% required NICU admission, and neonatal mortality was 1.59%. Conclusion: Teenage pregnancy is associated with significant fetomaternal complications, particularly anemia and preterm birth. Recommendation: Strengthening adolescent health education, delaying the age at marriage, improving access to antenatal care, and implementing nutritional interventions are essential to reducing adverse outcomes.
Copyright (c) 2026 Avasmica Toppo, Mahija Sahu, Sabyasachi Padhi, Arati Behera (Author) https://creativecommons.org/licenses/by/4.0
Prevalence and immediate adverse birth outcomes following augmentation of labor with oxytocin at Mbarara Regional Referral Hospital, Southwestern Uganda. A cross-sectional study.
Background: Augmentation of labor using oxytocin is widely practiced to manage inadequate uterine contractions and prevent prolonged labor. However, its use has been associated with adverse maternal and perinatal outcomes, including uterine hyperstimulation, postpartum hemorrhage, fetal distress, and increased operative deliveries. This study assessed the prevalence and immediate adverse birth outcomes among women undergoing augmentation of labor at a tertiary hospital in Southwestern Uganda. Methodology: A hospital-based cross-sectional study was conducted from December 2024 to April 2025 among 210 women who delivered following oxytocin augmentation at Mbarara Regional Referral Hospital. Data were collected using a pre-tested questionnaire and clinical chart review. Immediate adverse birth outcomes were defined as maternal and/or perinatal complications occurring within 24 hours of delivery. Data were analyzed using Stata version 17 to determine prevalence and associated characteristics. Results: The prevalence of immediate adverse birth outcomes was 22.4% (95% CI: 17.2–28.6%). Adverse maternal outcomes alone occurred in 11.0% of participants, perinatal outcomes alone in 7.1%, while 4.3% experienced both. The most common maternal outcomes were caesarean section (6.2%) and postpartum hemorrhage (5.2%). Among perinatal outcomes, low Apgar score (<7 at 5 minutes) and neonatal intensive care unit admission were most frequent (8.1% each). Referral status and marital status showed significant associations with adverse outcomes. Conclusion: The prevalence of immediate adverse birth outcomes following oxytocin augmentation is high, highlighting a significant obstetric concern. Both maternal and neonatal complications remain common in this setting. Recommendation: Strengthening adherence to labor monitoring protocols, particularly the use of the WHO labor care guide, and careful selection and monitoring of women undergoing oxytocin augmentation are essential to reduce adverse birth outcomes.
Copyright (c) 2026 Dr. Dickens Mugumya, Dr. Onesmus Byamukam, Assoc. Prof. Rogers Kajabwangu, Musa Kayondo, Leevan Tibaijuka, Joseph Ngonzi, Daniel Begumana, Mohamed Bashir, Edwin Semambo, Julius Businge, Paul Kato Kalyebara (Author) https://creativecommons.org/licenses/by/4.0
Maternal and Neonatal Outcomes Following Prophylactic Oxytocin versus Carbetocin After Vaginal Delivery: A Prospective Observational Study
Background Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality worldwide. Prophylactic uterotonics are central to active management of the third stage of labour. Oxytocin is widely used after vaginal delivery, whereas carbetocin, a long-acting oxytocin analogue, may provide more sustained uterine contraction and better control of postpartum blood loss. Objectives To compare maternal and neonatal outcomes following prophylactic oxytocin versus carbetocin after vaginal delivery. Methods This hospital-based cross-sectional comparative study was conducted at RVM Institute of Medical Sciences and Research Centre, Laxmakkapally, Telangana, India, from January 2025 to August 2025. A total of 100 women undergoing vaginal delivery were included. Based on the prophylactic uterotonic administered during the third stage of labour as part of routine clinical care, 50 women received oxytocin and 50 received carbetocin. Maternal outcomes assessed were duration of the third stage of labour, estimated blood loss, postpartum hemorrhage, requirement of additional uterotonics, and adverse effects. Neonatal outcomes included birth weight, Apgar scores, and neonatal intensive care unit admission. Results The mean maternal age of the participants was 25.8 ± 3.9 years, and the majority were multiparous women. Baseline demographic and obstetric characteristics were comparable between the two groups. The carbetocin group showed a shorter duration of the third stage of labour and lower mean estimated blood loss than the oxytocin group. Postpartum hemorrhage and the need for additional uterotonics were less frequent among women who received carbetocin. Adverse effects were mild and comparable in both groups. Neonatal outcomes, including birth weight, Apgar scores, and NICU admission, did not differ significantly between the groups. Conclusion Carbetocin demonstrated better maternal haemostatic outcomes than oxytocin after vaginal delivery, while neonatal outcomes remained comparable. Recommendation Carbetocin may be preferred for postpartum hemorrhage prophylaxis after vaginal delivery, especially in women with anticipated increased bleeding risk.
Copyright (c) 2026 Dr Akula Swaroopa Rani, Dr Manjula D, Dr Alekya A, Dr Prashanth Kumar Patnaik (Author) https://creativecommons.org/licenses/by/4.0
Clinical profile, treatment response, and safety of tranexamic acid in postpartum hemorrhage. A cross-sectional observational study.
Background Postpartum hemorrhage (PPH) remains a major cause of maternal morbidity and mortality, and tranexamic acid (TXA) has emerged as an important adjunct in its management. Real-world evidence from tertiary care hospitals remains valuable for evaluating short-term treatment response and safety. Objectives To assess the clinical profile, treatment response, and short-term safety outcomes among women with PPH receiving TXA in a tertiary care teaching hospital. Methods This hospital-based observational study included 100 women with clinically diagnosed PPH who received TXA as part of standard management at RVM Institute of Medical Sciences and Research Centre, Telangana, India, from February 2025 to September 2025. Demographic, obstetric, etiological, therapeutic, and outcome-related variables were recorded and analyzed using descriptive statistics. Results Most women were aged 21-30 years, multiparous, and delivered vaginally. Uterine atony was the commonest cause of PPH. TXA was administered within 1 hour of diagnosis in 64% of women. Estimated blood loss remained below 1000 mL in 68% after treatment. Additional uterotonics and blood transfusion were required in 32% and 28%, respectively. Hemorrhage was controlled with medical management alone in 78%, whereas 20% required surgical intervention and 3% underwent hysterectomy. Recovery without major complication occurred in 86% of women; ICU admission was required in 11%, and maternal mortality was 2%. Adverse effects were infrequent, with nausea or vomiting in 6%, transient hypotension in 3%, and no thromboembolic events observed. Conclusion In this observational cohort, TXA used as part of multimodal PPH management was associated with favorable hemorrhage control and a low short-term adverse-event burden. These findings support its continued integration into tertiary care obstetric hemorrhage protocols. Recommendation Early administration of tranexamic acid should be encouraged in postpartum haemorrhage management to reduce blood loss, complications, and improve maternal outcomes.
Copyright (c) 2026 Dr Manjula D, Dr Akula Swaroopa Rani, Dr Vidyullatha Balivada, Dr Prashanth Kumar Patnaik (Author) https://creativecommons.org/licenses/by/4.0
Incidence of Post-Cesarean Surgical Site Infection With Cefazolin Alone Versus Cefazolin Plus Azithromycin Prophylaxis: A Hospital-Based Observational Cohort Study
Background Surgical site infection after cesarean delivery remains a significant cause of maternal morbidity, prolonged hospitalization, readmission, and increased treatment cost. Objectives To compare the 30-day cumulative incidence of post-cesarean surgical site infection between women receiving cefazolin alone and those receiving cefazolin plus azithromycin, and to identify clinical factors associated with infection. Methods This hospital-based observational cohort study was conducted at a tertiary care teaching hospital in Telangana, India. A total of 100 women undergoing cesarean delivery were enrolled and categorized according to prophylaxis received: cefazolin alone [n=50] or cefazolin plus azithromycin [n=50]. The primary outcome was surgical site infection within 30 days. Secondary outcomes included febrile morbidity, prolonged hospital stay, readmission due to infection, need for resuturing or drainage, and postoperative wound discharge. Demographic, obstetric, and perioperative variables were also assessed. Results Baseline demographic and obstetric characteristics were comparable between groups. During 30-day follow-up, 10 of 100 women developed surgical site infection, yielding a cumulative incidence of 10.0%. Infection occurred in 14.0% of the cefazolin-alone group and 6.0% of the combination group, with an absolute risk difference of 8.0 percentage points; however, the difference was not statistically significant [p=0.18]. Superficial incisional infection was the most frequent type [7.0%], followed by deep incisional infection [2.0%] and organ/space infection [1.0%]. Secondary infectious outcomes were consistently lower in the combination group. Surgical site infection was significantly associated with BMI ≥30 kg/m², rupture of membranes >12 hours, and operative duration >60 minutes. Conclusion Cefazolin plus azithromycin prophylaxis was associated with a lower 30-day risk of post-cesarean surgical site infection and fewer postoperative infectious complications than cefazolin alone. Although the difference was not statistically significant, the overall trend favored adjunctive azithromycin. Recommendation Larger multicenter prospective studies are recommended to validate these findings and guide prophylactic antibiotic strategies for high-risk cesarean deliveries.
Copyright (c) 2026 Dr Vidyullatha Balivada, Dr Usharani Nagarapu, Dr Akula Swaroopa Rani, Dr Prashanth Kumar Patnaik (Author) https://creativecommons.org/licenses/by/4.0
Misoprostol Use for Induction of Labor at Term: Dose Patterns, Time-to-Delivery, and Complications: An Observational Study
Background Misoprostol is widely used for induction of labor at term because it is inexpensive, stable at room temperature, and effective for cervical ripening. Objectives To assess dose patterns, induction-to-delivery interval, delivery outcomes, and maternal and neonatal complications among women induced with misoprostol at term. Methods This hospital-based observational study included 100 term pregnant women induced with misoprostol at a tertiary care teaching hospital from April 2025 to November 2025. Baseline characteristics, indication for induction, number of doses, total dose, time to delivery, mode of delivery, and complications were recorded and analyzed descriptively. Results Most women were 21-30 years old, and 56% were primigravida. Postdated pregnancy was the commonest indication. Two doses were most frequently required, and the mean total dose was 63.5 ± 22.4 µg. The mean induction-to-delivery interval was 11.6 ± 4.8 hours and was longer in primigravida than multigravida women. Normal vaginal delivery occurred in 72%, instrumental vaginal delivery in 8%, and cesarean delivery in 20%, yielding an overall vaginal delivery rate of 80%. Uterine tachysystole occurred in 7%, hyperstimulation in 3%, postpartum hemorrhage in 4%, and NICU admission in 8%. Conclusion Misoprostol induction at term showed good effectiveness with an acceptable safety profile in routine tertiary care practice. Most women achieved vaginal delivery within a clinically reasonable interval, and serious maternal or neonatal complications were uncommon. Recommendations Misoprostol may be considered a safe and effective agent for induction of labor at term when used with appropriate dosing and monitoring. Further multicentric studies with larger sample sizes are recommended to establish optimal protocols and strengthen evidence-based clinical guidelines.
Copyright (c) 2026 Dr Usharani Nagarapu, Dr Alekya A, Dr Akula Swaroopa Rani, Dr Prashanth Kumar Patnaik (Author) https://creativecommons.org/licenses/by/4.0
Thyroid dysfunction and menstrual disorders in reproductive-age women: A prospective observational study in a tertiary hospital in Andhra Pradesh, India.
Background Thyroid dysfunction can disturb the hypothalamic-pituitary-ovarian axis and cause menstrual irregularities in reproductive-age women; early detection is important for accurate diagnosis and timely management. Objectives: To estimate the prevalence of thyroid dysfunction among reproductive-age women presenting with menstrual disorders and to evaluate the association between thyroid hormone categories and specific bleeding patterns. Methods A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Maharajah’s Institute of Medical Sciences (MIMS), Nellimarla, Vizianagaram, Andhra Pradesh, India, from August 2023 to February 2025. Women aged 18–45 years with menstrual irregularities were enrolled (n=160) after applying eligibility criteria and obtaining written consent. Clinical evaluation, pelvic examination, haemoglobin estimation, and transabdominal ultrasonography were performed. Menstrual blood loss was assessed using the pictorial blood loss assessment chart. Serum T3, T4, and thyroid-stimulating hormone (TSH) were measured, and participants were classified as euthyroid, hyperthyroid, hypothyroid, or subclinical hypothyroid. Associations were tested using the chi-square test. Results Overall, 33/160 women (20.62%) had thyroid dysfunction: hypothyroidism 22 (13.75%), subclinical hypothyroidism 8 (5.00%), and hyperthyroidism 3 (1.88%). Menorrhagia was the leading menstrual disorder (54, 33.75%), followed by amenorrhoea (47, 29.38%) and polymenorrhoea (36, 22.51%). Parity was significantly associated with thyroid status (p=0.04). Menstrual pattern showed strong associations with T3 (p<0.001), T4 (p<0.001), and TSH (p<0.001) categories; elevated TSH clustered with menorrhagia and polymenorrhoea, whereas low TSH was observed mainly among amenorrhoeic women. Weight gain and constipation were common hypothyroid-suggestive symptoms, while weight loss and fatigue suggested hyperthyroidism. Conclusion One in five women with menstrual disorders had biochemical thyroid dysfunction, predominantly hypothyroidism. Thyroid hormone derangements were significantly linked to the type of menstrual disturbance. Recommendations Thyroid function testing should be incorporated into the first-line evaluation of menstrual disorders in routine clinic practice, particularly heavy or frequent bleeding and persistent amenorrhoea.
Copyright (c) 2026 Dr. Durga Devi Meda, Dr . R V Durga Prasad, Dr. Guturu P.R.S.D.S Tejaswini, Dr. D.S.S.K.Raju (Author) https://creativecommons.org/licenses/by/4.0
Individual factors influencing the completion of antenatal care visits among pregnant mothers attending the ANC Clinic at Jinja Regional Referral Hospital. A cross-sectional study.
Background: The study aimed to assess the individual factors influencing the completion of antenatal care visits among pregnant mothers attending the ANC Clinic at Jinja Regional Referral Hospital. Methodology: A descriptive cross-sectional study was conducted at Jinja Regional Referral Hospital among pregnant mothers attending the antenatal clinic. A sample of 77 participants, derived from the Kish and Leslie formula, was selected using simple random sampling. Data were collected using semi-structured questionnaires, with assistance for illiterate respondents. Data were analyzed using Microsoft Excel and presented in tables and charts. Quality control included pretesting and piloting tools. Ethical approval, informed consent, confidentiality, and voluntary participation were ensured throughout the study. Standard procedures were followed for data collection. Results: Most respondents (96%, n=74) had attended school, mainly up to secondary level (47.3%, n=35), while 25.7% (n=19) reached tertiary education. The majority (74%, n=57) were currently employed, with farming being the most common occupation (40.5%, n=23), while fewer worked as professionals such as nurses and teachers (25.7%, n=15). Most participants (68%, n=52) initiated antenatal care within the first trimester, whereas 32% (n=25) started later. Decision-making on seeking health care was limited, as 60% (n=46) reported not making their own decisions, compared to 40% (n=31) who did. Regarding alcohol use, 55% (n=42) had never consumed alcohol, while 45% (n=35) reported prior consumption. Conclusion: Education, employment, decision-making ability, and alcohol use influenced ANC completion. Recommendation: The government of Uganda should ensure antenatal care services are provided free of charge to improve access and utilization.
Copyright (c) 2026 Norah Nannyonga, Mr Moses Ojale, Hasifa Nansereko, Francisco Ssemuwemba, Jane Frank Nalubega, Immaculate Prosperia Naggulu (Author) https://creativecommons.org/licenses/by/4.0
Individual factors associated with vulvovaginal candidiasis among non-pregnant women attending Hoima Regional Referral Hospital. A Descriptive cross-sectional study.
Background: This study evaluated individual-level determinants of VVC among non-pregnant women attending Hoima Regional Referral Hospital. Methodology: A descriptive cross-sectional study involving 77 respondents was conducted using structured questionnaires. Data on medical history, hygiene practices, personal behaviors were collected and analyzed using descriptive statistical methods. Results: Most of the respondents, 20(30%), were aged between 30 and 39 years, whereas the least, 10(13%), were above 50 years. Most 39(50.6%) of the respondents were married, whereas the least 5(5.6%) were widowed. Most 37(48.1%) of the respondents had a secondary school level of education, while the least 5(6.5%) had no formal level of education. 26(33.8%) of the respondents were self-employed, whereas the least 8(10.4%) of them were just employed. About 57(74%) of the respondents lived in rural areas while the least 20(26%) lived in urban areas. Of the respondents diagnosed with VVC (46.8%), a significant proportion (63.9%) reported having chronic illnesses, particularly diabetes, which compromises immune function and increases infection risk. Regarding recurrence, 77.8% experienced at least one yeast infection within the past 12 months, indicating a high recurrence rate. Hygiene practices revealed mixed patterns; while 55.6% reported changing underwear daily, potentially protective, 38.9% engaged in vaginal douching or used feminine hygiene sprays, practices known to disrupt normal vaginal microbiota. Symptomatically, 72.7% reported classic signs such as itching, burning sensation, and abnormal discharge, confirming active infection. These findings demonstrate that both physiological vulnerabilities and modifiable behaviors significantly contribute to VVC occurrence and persistence. Conclusion: Individual health status and behavioral practices play an important role in the occurrence and recurrence of vulvovaginal candidiasis. Chronic illnesses such as diabetes and certain hygiene practices can increase the risk of infection. Recommendations: Health education should emphasize proper genital hygiene and discourage harmful practices like douching.
Copyright (c) 2026 Vincent Mukonyezi, Tobius Mutabazi, Hasifah Nansereko, Franscisco Ssemuwemba, Jane Frank Nalubega (Author) https://creativecommons.org/licenses/by/4.0
Uptake of cervical cancer screening services among women of reproductive age attending Hoima regional referral hospital. A cross-sectional study.
Background: Cervical cancer is the fourth most common cancer in women globally, but for those in their prime reproductive years, it is the second most frequent threat. It is almost entirely preventable with regular screening and early detection. The study aimed to assess the individual, health care system-related, and social and cultural factors affecting uptake of cervical cancer screening among women of reproductive age attending Hoima Regional Referral Hospital. Methodology: The study adopted a descriptive cross-sectional design, with the use of semi-structured questionnaires. Simple random sampling was used to obtain 60 respondents, and data were collected with the help of semi-structured questionnaires. Collected data was analysed using Microsoft Excel and presented in the form of tables and figures. Results: More than half of the respondents, 44(73.3%), felt uncomfortable with cervical cancer screening because it involves genital examination. While 31(51.7%) avoided being screened for cervical cancer due to long waiting time, 51.7% avoided it because they had been discouraged by their partners. Even though 84.6% reported that they would go for screening if given adequate information about cervical cancer screening, fear of results, 61.7%, and preference for a specific gender of health workers seemed to be influencing factors. Conclusions: Key barriers to seeking care include long wait times, partner discouragement, and a fear of results. Additionally, the gender of health workers plays a role in their decision-making. However, there is a strong willingness to undergo screening if adequate information and education are provided. Socio-cultural factors included feeling ashamed of the procedure and being refused by partners. Recommendations: The hospital administration should work towards improving the quality and accessibility of cervical cancer screening services by reducing long waiting times, improving staffing levels, and introducing organized appointment systems.
Copyright (c) 2026 Mariam Nankwanga, Moses Ojale, Hasifa Nansereko, Franscisco Ssemuwemba, Jane Frank Nalubega, Immaculate Prosperia Naggulu (Author) https://creativecommons.org/licenses/by/4.0