Aim:The purpose of the study is to discuss about the presentation and management of adolescent adnexal torsion at ESIC Medical College and PGIMSR. Materials and methods: This is a case series study of adolescents with adnexal torsion, from December 2019 to March 2022 at ESIC Medical College and PGIMSR, Chennai, Tamil Nadu, India. Detailed history and clinical examination followed by ultrasonography with Doppler pelvis were done. The type of surgery and the histopathological findings were studied. Written informed consent was taken from all the subjects for publishing the data and images. Results: All patients presented with acute onset of abdominal pain. Eight patients had vomiting. Six patients had right-sided torsion and four patients had left-sided torsion. Laparotomy was done for nine cases. A laparoscopy was done for one case. Only two patients underwent salpingo-oophorectomy due to necrotic changes. The ovary was preserved in eight patients. Two patients had oophoropexy done. One was for recurrent torsion and the other case had undue long ovarian ligament and fallopian tube. Conclusion: Adnexal torsion is a gynecological emergency and requires early surgical intervention. Adnexal torsion in adolescents is usually due to benign functional ovarian cysts and benign teratoma. Malignant ovarian tumors are rare in the adolescent age-group. The goals of surgery are detorsion and preservation of the ovary regardless of its appearance at the time of surgery. Oophorectomy is required only when the ovary is severely necrotic and falls apart. Clinical Significance: Minimally invasive surgical approach with detorsion of adnexa and avoiding oophorectomy will lead to preservation of adnexal structures and their function.

Background: Up to 85% of the women experience some type of mood disturbance in the postnatal period. Postpartum depression affects bonding with infant which may lead to malnutrition and other complications in the infant. This article focuses on the prevalence of depression among postnatal women attending a tertiary care institute in Chennai and to identify the risk factors that affect postpartum depression.Methods: This study was a cross sectional study, performed over a period of three months from January 2019 to March 2019. 200 postnatal mothers were recruited for the study, who were in postpartum period from 1 to 6 weeks after delivery. Specially designed proforma was used to record various determinants to assess the risk factors which could contribute to postpartum depression. The Edinburgh Postnatal Depression Scale was used to detect the depressive symptoms in postnatal mother.Results: A total of 200 cases were studied. Prevalence of postpartum depression was found to be 25%. Primi gravida, history of miscarriage and unplanned pregnancy were associated with increased risk of developing depression in the postnatal period. Fear regarding gender of the child and failure of lactation were not contributing risk factors to postpartum depression. Spacious house and partner support were found to be protective factors to combat depression in postnatal women.Conclusions: Prevalence of postpartum depression was 25%. Significant association was found between primi gravida, history of miscarriage, unplanned pregnancy and postpartum depression. Early screening of the women will reduce the adverse outcomes among both mother and the child.

Background: Gestational diabetes mellitus (GDM) is associated with adverse maternal and fetal outcomes. Majority of the maternal complications associated with GDM have been decreasing nowadays, however the relative risk of development of perinatal complications remain higher in women with hyper glycaemia.Methods: This retrospective study was conducted among 286 delivered pregnant women. The pregnant women were diagnosed as GDM by DIPSI diagnostic criterion. The study was performed to find the association of various risk factors with GDM occurrence and to assess the obstetrical outcome in the GDM and normoglycaemic women.Results: Out of the 286 women, the proportion of women affected with GDM was 20.6%. The onset of GDM was more common among women between 25-30year (62.7%). GDM onset is increased when they had previous history of GDM and family history of diabetes.  The obstetric complications were less common among GDM women (23.72%). GDM women had increased rate of caesarean delivery (69.5%) and induction of labour (42.4%). The neonatal complications were more common among GDM neonates (57.62%). The proportion of occurrence of congenital anomalies and macrosomia (>3.5kg) was similar among both groups.Conclusions: Risk factors associated with GDM onset such as previous history of GDM and family history of diabetes are significant risk factors. Advanced age, increasing parity and occurrence of abortions were not associated with GDM onset.  With good glycaemic control the obstetrical complications and macrosomia are preventable. Rate of Induction of labour, caesarean delivery and neonatal morbidity remains higher among GDM women.

Background: Rates of caesarean delivery have increased over past 40 years. The increase has been attributed to liberalization of indications for caesarean sections. Repeat caesarean section is a major contributor to caesarean rates; Vaginal Birth After Caesarean (VBAC) is one of the methods to contain increasing caesarean rates. Success rates of 60-80% have been reported.Methods: This was a descriptive study involving 1000 pregnancies of period of gestation more than 28 weeks with history of one previous caesarean section. The women under study were subjected to either trial vaginal delivery or elective repeat caesarean delivery depending upon the clinical situation. The percentage of successful vaginal deliveries, factors responsible for failure of vaginal delivery and differences in outcome between successful vaginal delivery and caesarean delivery group were analyzed.Results: Out of the 1000 women, 423 underwent elective repeat caesarean delivery, of the remaining 577, 403 (69.8%) had successful vaginal delivery. Age of the woman and onset of labour were the only factors influencing the success of vaginal delivery. Women aged 35 years or more and women who needed labour induction had lower success of vaginal delivery. Maternal and perinatal outcome were worse in failed vaginal delivery group when compared to elective repeat caesarean delivery or successful vaginal delivery groups.Conclusions: Factors which are usually thought to influence the decision about trial vaginal delivery like prior vaginal delivery, indication for previous caesarean section and interpregnancy interval are not absolute in determining the decision or the outcome. Labour induction should be resorted with great caution in women with post caesarean pregnancy.