The study evaluates the effectiveness of maternal anthropometric measurements of our population with estimated fetal weight as an additional parameter to predict Cephalopelvic disproportion (CPD). Materials and Method:The prospective study conducted in a tertiary care center involved 353 primigravida over 37 weeks of gestation with singleton pregnancy admitted at Nazareth hospital, Shillong, Meghalaya, India. Anthropometric measurements included maternal height, bis-acromial diameter, foot length, estimated fetal weight and vertical and transverse rhomboid diameters. Based on mode of delivery, patients were divided into two groups -CPD group and No CPD group. Results: Out of 353 patients, 141 (40%) had CPD and 212 (60%) had no CPD. High positive predictive values for CPD was demonstrated for maternal height, foot length, bis-acromial diameter and rhomboid dimensions. The risk factors predicted for CPD in this study were height ≤142 cm, foot length ≤20cm, Bisacromial diameter ≤ 32.5 cm, Michaelis rhomboidtransverse and vertical diameters ≤9 cm and 9.5 cm, respectively, and estimated fetal weight ≥3255 gm. Conclusion: Generally, the women in this region are of short stature with an average height of 142 cm. The anthropometric measurements of this population vary from the other populations accordingly. Hence, knowledge of these parameters and their usage will help in early CPD anticipation and timely referral of these patients to tertiary centers. Measuring maternal and fetal parameters is easy and a reproducible skill that can be transferred to midwives in the rural area for better antenatal care.

Uterine rupture is one of the main contributory factors of maternal morbidity and fetal mortality. The aim of this study was to study the maternal and perinatal outcome in rupture of unscarred uterus and to identify the etiology, risk factors, diagnosis and management in a tertiary care centre. This case series study was often cases of rupture of unscarred uterus conducted at the department of obstetrics and gynecology, Nazareth hospital, Shillong, Meghalaya from July 2018 to February 2021. During the study period there were 7840 deliveries and ten patients presented with rupture of unscarred uterus, the incidence being 0.127 %. The patients were referred from different primary health centres and all patients presented with history of trial of home delivery. All patients were multigravida and the highest parity was a patient with para 11. The cases were between the gestational age of 39 to 41 weeks. Rupture was observed in the lower uterine segment in 5 patients, left lateral wall in 3 and right lateral wall in 2 patients. Five patients underwent hysterectomy, and 4 patients had repair of the rupture. There was one maternal death. Grand multipara and trial of home delivery were the most common identifiable risk factors along with obstructed labour. Identifying high risk women, prompt diagnosis, early referral from periphery and active management is the key factor to avoid adverse maternal and perinatal outcome.