To compare the efficacy of oral nifedipine with intravenous labetalol in the treatment of severe hypertension in pregnancy.It was a double-blind, randomized, controlled study conducted in pregnant women with blood pressure ≥160/110 mm Hg. Total 60 patients were enrolled from October 2016 to September 2017. Patients were randomized to receive nifedipine (10 mg tablet orally up to five doses) and intravenous placebo saline injection or intravenous labetalol injection in doses of 20, 40, 80, 80, and 80 mg and a placebo tablet every 20 minutes until the target blood pressure of ≤ 150/100 mmHg was achieved. The primary outcome of the study was time necessary to achieve target blood pressure. Secondary outcome were number of doses required, onset of labour, mode of delivery, adverse maternal and neonatal effects, side effect, and perinatal outcome. The time to achieve the blood pressure goal was significantly shorter with nifedipine (mean ± SD, 34.67 ± 20.297 minutes) than with labetalol (52.00 ± 29.054minutes; P <.017). Nifedipine group required significantly lower doses (mean ± SD, 1.73±1.015) as compared to labetalol (2.60±1.453, p<0.017). Urine output was significantly increased in nifedipine group (mean ± SD, 2296 ± 210.483 ml) compared with labetalol group (1374 ± 155.798 ml, P < .0001) and remained significantly increased 24 hours after initial administration. No patients required crossover therapy. The a dverse effects were infrequent. There were no significant differences in maternal age, gestational age, and blood pressures between the groups. Oral nifedipine and intravenous labetalol both are effective in the management of severe hypertension of pregnancy; however, nifedipine controls hypertension more rapidly with less number of dos es and was associated with a significant increase in urinary output.

Mullerian duct anomalies (MDAs) are congenital defects of the female genital system that arise from abnormal embryological development of the Mullerian ducts. Congenital uterine anomaly is a risk factor for preterm, low birth weight and malpresentations. In our case report cesarean section was done for breech presentation and it was an incidental intra operative finding of unicornuate uterus with rudimentary horn.

The haemoglobinopathies are autosomal recessive inherited disorders of haemoglobin synthesis (thalassaemias) or structure (sickle cell disorders) that are responsible for significant morbidity and mortality on a worldwide scale. Screening is necessary in pregnancy because of the complications to mother as well as fetus. NESTROFT is a suitable test for screening for beta-thalassaemia and the common haemoglobinopathies seen in India. But HPLC remains the gold standard for detection of thalaseemia. Pregnancy thalaseemias should be considered a high-risk pregnancy and requires proper antenatal and postpartum management with follow up of fetal outcome.

Couvelaire uterus or uteroplacental apoplexy is a severe form of abruption where there is widespread extravasation of blood into the uterine musculature and beneath the serosa. It is one of the complication of abruption placentae in which myometrial wall is infiltrated by blood leading to classic ecchymotic uterus appearance. In our case, there was concealed abruption placentae with no significant predisposing factor being revealed in history. Preoperatively, there was retroplacental clot with couvelaire uterus but with no post operative complication.