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Bhabani Pegu,Bheemanathi Hanuman Srinivas,Thangamuthu Sri Saranya,Rajeswari Murugesan,Smitha Priyadarshini Thippeswamy,Bhanu Pratap Singh Gaur 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.6
ObjectiveTo determine the frequency of premalignant and malignant lesions in cervical polyps in order to examine whethercervical polyps need to be removed routinely and also to appraise its association with cervical smear cytology andendometrial pathologies. MethodsWe retrospectively re-examined the hospital records of 299 cases over a period of 5 years. All patients weresegregated into perimenopausal and postmenopausal groups according to their menopausal status. The groupswere compared in terms of histological results of cervical polyp biopsy, endometrial pathologies, and cervical smearcytology. Pearson’s χ2 test and Fisher’s exact test were used for statistical analysis, and a P-value of <0.05 was acceptedas statistically significant. ResultsIn the histopathological reports of cervical polyps, premalignant lesions were found in 2% of cases, and only 0.3%of malignant lesion was observed in menopausal women. Subsequently, no malignancy was noted in cervical smearcytology for both groups. Premalignant and malignant lesions in endometrial histopathology findings were 1.33%and 0.66%, respectively. There was a statistically significant association between the menopausal status of the patientand cervical smear cytology and endometrial pathology, but the histological findings were not statistically significantin relation to the symptomatic status of the patients. ConclusionAs per the results, we strongly suggest the removal of all cervical polyps with subsequent histological review. Theevaluation of cervical smear cytology prior to polypectomy can provide information about its malignancy potential. We believe that along with cervical polypectomy,endometrial sampling should be recommended,especially for postmenopausal women.
Placenta accreta spectrum-a catastrophic situation in obstetrics
Bhabani Pegu,Chitra Thiagaraju,Deepthi Nayak,Murali Subbaiah 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.3
Placenta accreta is a significant obstetric complication in which the placenta is completely or focally adherent to themyometrium. The worldwide incidence of placenta accreta spectrum (PAS) is increasing day by day, mostly due tothe increasing trends in cesarean section rates. The accurate and timely diagnosis of placenta accreta is important toimprove the feto-maternal outcome. Although standard ultrasound is a reliable and primary tool for the diagnosis ofplacenta accreta, the absence of ultrasound findings does not preclude the diagnosis of placenta accreta. Therefore,clinical evaluation of risk factors is equally essential for the prediction of abnormal placental invasion. Pregnantwomen with a high impression or established diagnosis of placenta accreta should be managed by a multidisciplinaryteam in a specialist center. Traditionally, PAS has been managed by an emergency obstetric hysterectomy. Previously,few studies suggested a satisfactory success rate of conservative management in well-chosen cases, whereas fewstudies recommended delayed hysterectomy to reduce the amount of bleeding. The continuously increasing trends ofPAS and the challenges for its routine management are the main motives behind this literature review.
Group Antenatal Care: A Paradigm Shift to Explore for Positive Impacts in Resource-poor Settings
Gaur, Bhanu Pratap Singh,Vasudevan, Jyothi,Pegu, Bhabani The Korean Society for Preventive Medicine 2021 Journal of Preventive Medicine and Public Health Vol.54 No.1
The delivery of high-quality antenatal care is a perennial global concern for improving maternal and neonatal outcomes. Antenatal care is currently provided mainly on a one-to-one basis, but growing evidence has emerged to support the effectiveness of group antenatal care. Providing care in a small group gives expectant mothers the opportunity to have discussions with their peers about certain issues and concerns that are unique to them and to form a support system that will improve the quality and utilization of antenatal care services. The aim of this article is to promote group antenatal care as a means to increase utilization of healthcare.