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Research Journal of Obstetrics and Gynecology
eISSN: 2077-222X
pISSN: 1994-7925

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Research Article
Robson Ten Group Classification System for Analysis of Cesarean Sections in an Indian Hospital
Arpita Y. Reddy, Anita Dalal and Romana Khursheed
Background and Aim: Cesarean section (CS) is the most commonly performed life-saving procedure. However, CS is associated with its own risks for maternal and perinatal morbidity and mortality in present as well as subsequent pregnancies. There is increase in cesarean section rates globally. Cesarean section audits are an important tool to understand and make recommendations for a possible reduction in cesarean delivery rates. Hence, the current study analyzed leading groups contributing to high cesarean section rates at a teaching hospital, by using Robson’s Ten Group Classification System (RTGCS). Materials and Methods: The present study was conducted in the Department of Obstetrics and Gynecology at teaching hospital attached to KLE Academy of Higher Education’s Jawaharlal Nehru Medical College, Belagavi, Karnataka, India. All the pregnant women who delivered ‘between’ January, 2016 to December, 2016 in the labour wards were included in the study and classified according to Robson’s Ten Group Classification System (RTGCS). Results: A total of 6236 women were delivered. Out of which 3454 (55.38%) women delivered vaginally and 2782 (44.61%) women delivered through cesarean section. In this study, Group 5 was the largest contributor to the cesarean section rate 18.6% whereas, group 1 was second highest (8.1%). Group 1 (31.9%) and 3 (21.4%) contributed to most of the obstetric populations. However, Group 6, 7, 8 and 9 contribution to overall cesarean section rate was 1.7, 1.2, 1.4 and 0.5%, respectively. Group 10 also contributing significantly to cesarean section rate (4.4%). Conclusion: The study revealed that Group 1, 2 and 5 contributed to high cesarean section rate. Thus, changing the norms for non-progress of labour and fetal distress, training and encouraging obstetricians to perform versions when not contraindicated could reduce the cesarean section rate. Trial of Labour after Cesarean (TOLAC) should be offered to women with previous CS after proper patient selection and counseling the pregnant women regarding its risks and benefits.
Research Article
Relationships of Malondialdehid and Sflt-1 with Maternal and Neonatal Outcome in Preeclampsia: An Observational Analytic Study
Ariadi , Yusrawati and Joserizal Serudji
Background and Objective: Increased Malondialdehyde (MDA) will cause endothelial damage and dysfunction. Soluble fms-like tyrosine kinase-1 (sFlt1) is known increase in amniotic fluid in preeclamptic patients. This study was aimed to determine the relationship between MDA and sFlt1 with maternal and neonatal outcome in preeclampsia. Materials and Methods: This was an observational analytic study with cross sectional study design. The sample size was 35 samples of pregnant women with preeclampsia. Sampling was done by consecutive sampling, from obstetrician’s practice at RSUP. Dr. M. Djamil Padang, RSI. Ibnu Sina Padang and RSU. BMC Padang. After maternal and neonatal examination and measurements MDA and sFlt1 levels of cubital venous blood by using Enzyme-Linked Immunosorbent Assay (ELISA) method, Pearson correlation was performed to assess the relationship between variables for normally distributed data and Spearman’s correlation for abnormal distribution data with significance level p<0.05. Result: This study found MDA associations with maternal and neonatal outcomes were systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), infant weight, infant length, apgar score I and apgar score II which obtained p<0.001, r = 0.587, p = 0.011, r = 0.356, p<0.001, r = 0.497, p = 0.005, r = 0.393, p = 0.001, r = 0.448, p = 0.063, r = 0.265 and p = 0.020, r = 0.328. The relationship of sFlt1 with maternal and neonatal outcome found p = 0.984, r = 0.003, p = 0.783, r = 0.040, p = 0.758, r = 0.045, p = 0.471, r = 0.104, p = 0.292, r = 0.152, p = 0.639, r = 0.068 and p = 0.707, r = 0.055. Conclusion:There was relationship between MDA with maternal and neonatal outcomes except for apgar score in the first minute. There was no relationship between sFlt1 with materal and neonatal outcome.

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