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Background: Idukki is a hilly tract area in the state of Kerala. No studies regarding menopause has been reported from Idukki. This study is done among postmenopausal women in an attempt to shed light on the prevalence of menopausal symptoms and perceptions of postmenopausal women in a panchayat in Idukki district which is typically a rural area. Primary objectives of the study were to find the prevalence of menopausal symptoms in post-menopausal women attending the outpatient department of Government Medical College, Idukki, India and to find the perceptions about menopause among these post-menopausal women. Secondary objectives were to find the mean age and pattern of attainment of menopause among postmenopausal women and to find the treatment seeking behavior of the post-menopausal women residing in this area.Methods: A cross-sectional observational study is done among 100 postmenopausal women attending the outpatient department of Obstetrics and Gynaecology. Questions are asked based on interview schedule. The results are then analyzed.Results: The mean age of menopause was 45.69± 4.35. 78% of population had one or more symptoms in the menopausal period. Only 19.5% of the symptomatic women took treatment. 77% had positive perceptions.Conclusions: The awareness of these women in this area is poor thus limiting the treatment seeking behavior. Improvement of awareness is a must to improve the quality of life of post-menopausal women.

BACKGROUNDAccurate measurement of gestational age is important for obstetric management. Ultrasound estimation of gestational age is the standard practice. Several biometric parameters can be used to calculate gestational age, commonest being biparietal diameter (BPD), abdominal circumference (AC) and femoral length (FL). In the present study, an additional parameter, the fetal renal length (KL), is taken as a biometric variable and the correlation between gestational age and renal length are calculated. AIMS-To find out the correlation between gestational age and kidney length, biparietal diameter, femoral length and abdominal circumference in the third trimester. To find out regression equations for these variables with gestational age and thus to predict gestational age. MATERIALS AND METHODSThe study was done as a cross sectional study. This study was conducted among 100 low risk antenatal women, who attended the antenatal clinics of the Department of Obstetrics and Gynaecology, Government Medical College, Thiruvananthapuram. Statistical Analysis-The data collected in the study concerning biometry and gestational age is represented in graph form called scatter diagram. Depending on the alignment of the data, the correlation between the two is visualized. Then curve fitting is done using regression analysis and regression equation for calculating the dependent variable from independent variable is found out using linear regression analysis. The coefficient of correlation (R) and coefficient of determination (R 2 ) is then found out. The better the correlation the closer these coefficients will be to one. Root mean square deviation shows how accurate is the estimate. RESULTSThe average gestational age of the study population was 35.6 ± 2.81. When comparing the correlation, it was found that kidney length had the highest correlation followed by femoral length. Regression equations for calculating gestational age from the various biometrics were calculated. Correlation was greatest when combination of KL, BPD, AC, FL and AC was used. RMSD was least with KL. The prediction interval width was least for KL. CONCLUSIONKidney length can be used along with the usual biometric variables like BPD, AC and FL with better accuracy for predicting gestational age.

BACKGROUND Caesarean Section is on the rise all over the world. Women undergoing Caesarean section often wish to be awake post operatively and to avoid excessive medications affecting interactions with the new born infant. Multimodal pain therapy has been advocated for postoperative pain management after caesarean section.

Background: Primigravida with mobile head at ≥39 weeks of gestation are prone to the probability of caesarean section. With this study we aimed to identify the maternal and neonatal outcome of primigravida with mobile head at ≥39 weeks of gestation under the watchful expectancy and good conduct of labour.Methods: A cross sectional study was conducted among primigravida with mobile head at ≥39 weeks admitted for delivery in the department of obstetrics and gynaecology, govt. medical college, Kottayam, Kerala, from February 2021 to September 2021. A sample size of 247 was identified considering 28% proportion of presentation with deflexed head, 95% confidence interval and 2% margin of error. A detailed history, physical examination and ultrasonography was performed.Results: Of the 250 participants, the mean age of the study subjects was 24.97±3.93 and mean body mass index (BMI) was 23.72±4.78 kg/m2. The most common cause for mobile head was a deflexed head (35.2%). A lower segment caesarean section (LSCS) was conducted in 28.8% participants while vacuum assistance ad forceps assistance was required for 9.6% and 4.4% participants respectively. The most common indication for LSCSC being moderate to thick meconium-stained amniotic fluid (MSAF) 23% followed by 1st degree CPD failed trial in 17% cases. A significant association with maternal morbidity was observed in undiagnosed placenta previa (p=0.039) and vacuum-assisted deliveries (p=0.001). We observed that 3.6% of babies have meconium aspiration syndrome, and 8% of new born were admitted in intensive care for foetal distress.Conclusions: Primigravida with mobile head at term during labour requires intense monitoring. Although the duration of labour appeared to be prolonged in a small proportion of patients with watchful expectancy and good conduct of labour and timely intervention, vaginal delivery is possible with minimal maternal and neonatal morbidity.