Subrat Panda

By Subrat Panda, Ananya Das, Arindam Mallik and Surajit Ray Baruah

Puerperium is the time following delivery during which pregnancy-induced maternal anatomical and physiological changes return to the nonpregnant state. Puerperium period of 6 weeks can be divided into: (a) immediate – within 24 hours (b) early – up to 7 days (c) remote – up to 6 weeks. The puerperal effects are seen in all organs and particularly in reproductive organs. Infection and haemorrhage are the common postpartum complications. Post partum care is very important. Advice on exclusive breast feeding and contraception is also mandatory after every childbirth.

Part of the book: Empowering Midwives and Obstetric Nurses

By Subrat Panda, Ananya Das, Kaushiki Singh, Prateeti Baruah and Anusuya Sharma

Ectopic pregnancy is defined as the implantation of a fertilised egg outside the uterine cavity. The site of ectopic pregnancy are Fallopian tube. Cervix, ovary, peritoneal cavity, or uterine scars. Other two site of implantation are cornual pregnancy and interstitial pregnancy. Diagnostic tests for ectopic pregnancy include a urine pregnancy tests, Serum beta hcG and ultrasound. The instant result of a urine pregnancy test is a useful pointer for the clinician to suspect an ectopic pregnancy. The test is a useful triage tool for clinicians to rule out a pregnancy when the clinical situation is not clear such as a patient who is not sure of dates, does not remember or is in a state of shock and the history cannot be elicited. Ultrasound remains the mainstay of the diagnosis and high index of suspicion and a detailed history are pre-requisite of scanning. Different ultrasonography feature are diagnostic of different site of implantation. For uterine scar pregnancy ultrasonologic criteria are not validated still now.

Part of the book: Ectopic Pregnancy and Prenatal Diagnosis

By Subrat Panda, Rituparna Das, Lisley Konar and Manasi Singh

PCOS is a multifactorial syndromic disorder—the exact etiology is not known. Genetic, epigenetic, and environmental factors may be the causative factors. It is the most common cause of an-ovulatory infertility, and in adolescents, the young girl may present with irregular periods. Most of the women with PCOS are either overweight or obese. Another variety of PCOS women is lean. Sleep apnea, metabolic syndrome, and endometrial carcinoma are the late consequences of women with PCOS. As new research shows that gut microbiome is one of the attributing factors of PCOS, it will lead to a new horizon in the management of PCOS. Fecal implantation or probiotics may be helpful in PCOS management. Physical and emotional stress is one of the contributing factors to PCOS. Neuroendocrine factors are also an attributive factor for the development of PCOS. Most of the research about neuroendocrine factors is very preliminary and limited to the mice model. The incidence of PCOS varies from region to region as dietary and environmental factors differ. More human research is required to have more knowledge about the etiology of PCOS, which will guide the management of PCOS.

Part of the book: Polycystic Ovary Syndrome