Background: Infertility affects 10-15% of reproductive age couples. Routine pelvic examination and usual diagnostic procedures can miss majority of the pelvic pathologies. Hysterolaparoscopy is an effective tool for diagnosing these pathologies and additionally therapeutic procedures, like polypectomy, myomectomy, septal resection and adhesiolysis, can be done in the same sitting. Objective of present study was to determine the role of diagnostic hysterolaparoscopy for evaluating the causes of infertility.Methods: It was a prospective study conducted at the Department of OBGY from September 2015 to August 2016. Patients aged 20-40 years with infertility were included in the study. The prevalence of different lesions was analysed.Results: Out of the 30 patients studied, most had primary infertility. Laparoscopic abnormalities (56.6%) were more common than hysteroscopic abnormalities (36.6%). Adnexal adhesions (26.6%) was the most common abnormality detected on laparoscopy, while the common intra-uterine pathologies were uterine septum and synechiae.Conclusions: Hysterolaparoscopy may be recommended as the procedure of choice for evaluation of female infertility, which are usually missed by imaging modalities.

No abstract

Active management of third stage of labour is an effective method of preventing postpartum hemorrhage. It includes administration of uterotonic immediately after delivery of the baby, delaying cord clamping for at least 1-3 minutes to reduce rates of infant anaemia, performing controlled cord traction for removing the placenta and postpartum vigilance, ie, assess the uterine tone to ensure a contracted uterus; and continue to check every 15 minutes for 2 hours. If there is uterine atony, fundal massage should be performed and patient should be monitored more frequently. Though oxytocin is the best drug for routine prophylaxis, misoprostol is a relatively newer drug which is now included in the various guidelines for prevention and treatment of postpartum hemorrhage. It can be used as an effective and safe drug in areas with poor access to skilled healthcare providers and facilities.

Background: The art of instrumental vaginal delivery is fading as more and more obstetricians resort to caesarean sections. Instrumental deliveries are deliveries accomplished with the use of vacuum device or forceps. Once either is applied to the foetal head, outward traction generates forces that augment maternal pushing to deliver the foetus vaginally. Objective of present study was to compare the maternal and foetal outcome of forceps versus ventouse delivery.Methods: It was a prospective observational study conducted in Sassoon Hospital between January 2014 to January 2015. A total of 120 cases, 60 each of forceps and ventouse, admitted in labour room were included in the study. Maternal and neonatal morbidity were compared in terms of perineal lacerations, episiotomy extension, post-partum haemorrhage, Apgar score, instrumental injuries. Chi square test and z test of proportion was used to analyze the data.Results: Maternal morbidity, namely episiotomy extension as well as perineal tears were significant in the forceps group. With regards to neonatal morbidity, no statistically significant difference was noted.Conclusions: Vacuum and forceps should remain appropriate tools in the armamentarium of the modern obstetrician. However, ventouse may be chosen first (if there is no foetal distress) as it is significantly less likely to injure the mother.

Background: In a time when repeat caesarean deliveries are becoming more frequent, more elective LSCS are being performed and floating vertex are commonly encountered. Sometimes fundal pressure is not adequate, and the physician needs to use instrument (vaccum/forceps) to deliver the head. The objective of the present study is to evaluate maternal and neonatal complications of intracaesarean forceps applicationMethods: This was an interventional study which was conducted in OBGY department of Sassoon General Hospital, Pune for 1 year. 75 cases including both emergency and elective sections were included in the study, in which intracaesarean outlet forceps was applied.Results: Out of 75 cases, maternal complications were seen in 5 cases with uterine incision extensions being the commonest (4%). Neonatal complications were seen in 3 cases, with minor facial injuries due to pressure of forceps being commonest (2.6%).Conclusions: Intracaesarean forceps when applied skillfully can be effective, fast and safe technique of delivering fetal head in this rising trend of caesarean sections.