Background: Caesarean delivery is defined as an operative procedure to deliver the fetus or foetuses after the period of viaility through an incision on the adominal wall and uterine wall in an intact uterus. The World Health Organization (WHO) has identified an ideal caesarean section (CS) rate for a nation of around 10-15%1. The objective of the present study was to find the rate of primary caesarean deliveries in and its contribution to total caesarean rate and to analyze the indications of the caesarean sections. Methods: It is a retrospective observational study conducted in the Department of Obstetrics and Gynaecology at Regional hospital,Bilaspur. A total of 90 primary caesarean deliveries were studied.   Results: The total deliveries during the study period were 809 and the total caesarean section rate observed was 14.96%. The caesarean section rate among primigravidae was 74.38%.  Out of the total number of primicaesarean deliveries, 92.22% were performed in emergency and 7.78% were performed electively. Among the emergency caesarean sections performed, 60.24% of patients had induced labor and 39.76% had spontaneous labor. The most common indication of caesarean section was fetal distress (43.33%) followed by failed induction(18.89%) and malpresentations (16.67%).   Conclusions: Caesarean audit should be performed routinely and every case should be scrutinised. Reducing the primary caesarean rate not only decreases total caesarean rate but also many long-term complications associated with previous caesarean sections like adherent placenta ,rupture uterus

No abstract

No abstract

Background: Labour is one of the most painful experiences women encounter during their lifetime and the experience is different for each women. Aim of the study was to evaluate the effect of low dose intrathecal labour analgesia using fentanyl, bupivacaine and morphine on maternal and fetal outcome.Methods: 100 parturients with uncomplicated pregnancy in spontaneous or induced labor at cervical dilatation 4-6cm were enrolled for the study. They were randomized into two groups of 50 each, using computer based block randomization. Group 1 (N=50) received intrathecal labor analgesia using. Fentanyl (25µg), bupivacaine (2.5mg) and morphine (250µg) and Group 2 (N=50) received programmed labor. The two groups were well matched in terms of age, weight, height, parity, baseline vitals and mean cervical dilatation at the time of administration of labor analgesia . Progress of labor, duration of analgesia, and neonatal APGAR score were recorded. Feto-maternal and neonatal outcomes were studied and compared between the two groups.Results: The mean duration of analgesia in group1 was 238.96±21.888 min whereas the mean duration of analgesia in group 2 was 98.4±23.505 min. The difference was significant P value 0.00. One out of 50 (2%) of the parturients required rescue analgesia in Group 1. On the contrary all 44 parturients in Group 2 required rescue analgesia. Difference was significant (p value=0.00) However duration of the stages of labor, operative and instrumental deliveries and APGAR score did not differ in the two groups.Conclusions: Single shot intrathecal labor analgesia is a safe, effective, reliable, cheap and satisfactory method of pain relief for labor and delivery. Moreover, it is devoid of major side effects.

Ovarian pregnancy is one of the rarest sites of non-tubal ectopic pregnancy. It has a prevalence of 0.5-3.5% in all ectopic pregnancies. It usually presents with rupture in the first trimester, a potential life-threatening condition. A preoperative diagnosis is difficult to make. Majority of the cases are diagnosed intraoperatively followed by confirmation on histopathology. We presented a case of 32-year-old woman with previous two normal deliveries at 7 weeks gestation who presented with abdominal pain and spotting. She was diagnosed with ruptured ovarian ectopic pregnancy on laparotomy and salpingo-oophorectomy was done. Later, ovarian pregnancy was confirmed on histopathology. The incidence of ovarian ectopic pregnancy is increasing and it should be considered as a differential diagnosis in women of childbearing age coming to emergency department with abdominal pain. It is important to keep a high index of suspicion for its diagnosis. High resolution transvaginal ultrasonography can help in earlier detection and preventing some of its complications like rupture, shock and maternal mortality.