Introduction: If the direction of the cervical canal is known, the commonly performed procedures as sono salpingography, embryo transfer, IUD insertion, cervical dilation etc. will be easier. The reported resultant trauma to the cervical canal and uterus during these procedures also can be avoided. As we know the cervical canal is tortuous in majority of cases, but the exact course is not yet reported or known. Objective: The objective of the present study was to try to identify the various directions of cervical canal while performing routine hysteroscopic surgeries. Methods: Four-point cervical canal direction was assessed while performing routine hysteroscopic procedures using 5fr Bettocchi operative assembly with 2.9 mm 12-degree telescope (Karl-Storz). The study group was patients with infertility who required hysteroscopy and laparoscopic evaluation as per infertility treatment protocol or else required hysteroscopy for AUB. The study was carried out at tertiary care referral hospital for minimal access surgeries for a period was of 2 yr. 9 months year from May 2017 to Feb 2020. Results: Down-right or left-up-straight combination of movement (DRUS, DLUS) was the most common cervical direction found in 72 % patients. If DURS (down-up-right-straight) movement is added these 3 movements together are seen in about 82% of patients. No cervical dilation is required when 5 fr hysteroscopic assembly was used in study group. No operative complications were found. Conclusion: DRUS and DLUS (down-right or left-up and straight) combination of movements are most frequent direction of cervical canal observed in 72% of patients.

Introduction: Knowledge of change in the duration of stages of labour would be an essential step to reduce the increasing rates of cesarean section reported worldwide. Objective: To study the rate of cervical dilation in the 1 st stage of labour in spontaneous and induced labour and in primigravida and multigravida with singleton pregnancy. Methods: A prospective observational study conducted at a multispeciality hospital was carried out for a period of 3 years from Jan 2017 to Dec 2019. A total of 640 patients who were admitted with spontaneous and induced labour having singleton pregnancy with cephalic presentation and intact membranes after 34 weeks who delivered vaginally were included for analysis. Progression of labor in the 1 st stage of labour was measured by the rate of cervical dilation as noted by serial per vaginal examination and findings were plotted in partograph. Result: The difference between mean rate of cervical dilation in the study group is statistically significant between 4-6 cm and 6-10 cm (P < 0.0001). When primigravida & multigravida patients were compared for the cervical dilation rate, statistically significant difference was seen between 4-6 cm but not in 6-10 cm. Average rate of cervical dilatation was 3.44 (Standard Deviation (SD) = 1.84) in spontaneous labor while average rate of cervical dilatation was 2.69 (SD = 1.18) in induced labor between 6-10 cm of cervical dilatation. Conclusion: The active phase of labour starts at 6 cm of cervical dilation in the majority of the patients. In multigravida, cervix dilates at faster rate before 6 cm. In induced labour cervix dilates at a slower rate than spontaneous labour after 6 cm dilation.

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