Background: Ectopic pregnancy is a global problem and is the most common life-threatening emergency in early pregnancy leading to significant morbidity and fetal loss. It occurs in variable presentations. The rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. The aim of this study was to determine the incidence, clinical presentation, risk factors, treatment, and morbidity and mortality associated with ectopic pregnancy.Methods: The present retrospective study was conducted over a period of three years in the department of obstetrics and gynecology at SMS and R, Greater Noida, UP from Feb 2014 to Jan 2017.A total of 80 patients with ectopic pregnancy were analyzed regarding clinical presentation, risk factors, operative findings and treatment modality.Results: Total number of 80 cases of ectopic pregnancies were admitted during this period against 2645 deliveries representing frequency of 3%. Majority of cases (43.75%) were in the age group of 25-29 years and 41.25% were gravida 4 and above. Risk factors were identifiable in 66.25% of cases. Previous abortion was the most common risk factor (31.25%). The classical triad of amenorrhea, pain abdomen and vaginal bleeding was present in 71.25% of cases. More than half of case (55%) had ruptured tubal pregnancy on admission. Unruptured tubal pregnancy was seen in 10% case. Interestingly we found one rare case of bilateral ectopic pregnancy. Salpingectomy by open method was the mainstay of treatment (86.25%).Conclusions: Ectopic pregnancy is still a major challenge in gynecological practice. In our country most of the cases present late after tubal rupture requiring radical surgical treatment. Early diagnosis and timely intervention in the form of medical treatment or conservative surgery not only reduces maternal morbidity but also preserves future fertility.

Background: Management of critically ill patients in obstetrics is a challenge owing to the changed physiology and unpredictability of the disease behaviour. Stratification strategy for early admission to obstetric ICU is imperative to reduce maternal morbidity and mortality. Due to lack of formal surveys regarding obstetrical ICU in our country, there is lack of precise national data on obstetrical ICU mortality. Aim of the present study was to estimate the obstetric ICU admission rate, to study the pattern of causative aetiology and to study the complications developed in ICU.Methods: The present study is a retrospective analytical study done in the Department of Obstetrics and Gynecology, from January 2015 to August 2017.Results: During the study period there were a total of 8466 obstetrical admissions, 2508 deliveries and 104 ICU admissions. Out of 104, analysis was done on 71 patients. Hypertensive disorders of the pregnancy were associated with maximum number of admissions (47.8%), followed by postpartum haemorrhage (12.6%). Maximum admissions were in postpartum period (63.4%). Anaemia was associated with 35.2% of the cases and it was closely followed by sepsis (28.2%). Mechanical ventilation was required for 30.9% of the patients.Conclusions: Hypertensive disorders of the pregnancy, haemorrhage and sepsis are the major risk factors for ICU admission in obstetric population.

Background: Reduction in the maternal morbidity has been the key strategy towards achievement of Millennium Development Goal. Despite exhaustive measures at all levels, the decline has been slow. WHO in 2007 established a technical working group to identify cases of severe acute maternal morbidity. It served dual goals to identify the causes and pointing out delays leading to SAMM. SAMM is now an established superior indicator of surviving women’s health and allows uniform comparisons. The present study was conducted with an aim to identify cases of SAMM at our centre. The objective is to determine the frequency of maternal near miss and conduct an epidemiological survey.Methods: This retrospective study was conducted in the department of Obstetrics and Gynecology and ICU of School of Medical Sciences and Research, Greater Noida, from November 2014 to October 2017. All the cases identified as SAMM, as per WHO 2009 criteria (modified according to the local protocol), were included in the study.  Results: During the study period there were a total of 2252 delivery, out of which 2051 were live births. There were 123 SAMM cases and 47 were excluded out of study. So, study was done on 76 cases of SAMM, and on 11 maternal deaths in the study period. Calculated MNM incidence ratio was 37.05 per 1000 live births. A mortality index of 12.64% was calculated. MNM to maternal death ratio was 6.9:1. Major identifiable cause for SAMM was hypertension (35.5%)), followed by haemorrhage (18.4%). Haematologic system was the commonest organ system involved. 67.8% of the admissions were done in critical condition.Conclusions: Maternal mortality and SAMM cases shared characteristics, and study of SAMM cases can provide an insight into the causative etiology and give time for early intervention.

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong><span lang="EN-US">Women undergo profound changes during pregnancy, making them susceptible to a number of dermatological manifestations. We aimed to determine the frequency and pattern of skin changes during pregnancy.</span></p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong><span lang="EN-US">A cross-sectional observational study was conducted among 400 pregnant women presenting to the Outpatient department of a Tertiary Care Centre in Northern India.</span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong><span lang="EN-US">A total of 400 pregnant mothers fulfilling inclusion criteria were included. The pigmentary changes were the most common physiological change seen in 90.8% (n=363) of pregnant women. The most common pigmentary change was secondary areola seen in 83% (n=332) women, followed by linea nigra seen in 37.5% (n=150) pregnant women. Vascular changes were seen in 13% (n=52), non- pitting pedal edema being the most common 10.25% (n=41). Connective tissue changes were seen in 62.25% (n=249) of pregnant women, striae gravidarum being the most common (n=242). The most common specific dermatoses of pregnancy was atopic eruption of pregnancy seen in 4.25% (n=17), followed by intrahepatic cholestasis of pregnancy (n= 14). 3 cases (0.75%) of Polymorphic eruption of pregnancy were seen. 1 case of Pemphigoid gestationis was seen in the third trimester. Approximately 17% of pregnant women were positive for infections among which fungal infection was the most common infection affecting pregnant women, seen in 11.2% (n=45) participants. </span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> The dermatoses of pregnancy are common and have a range of dermatological manifestations apart from their specific pattern; in order to manage and treat them appropriately, proper attention needs to be given.</span></p>

Background: Minimally invasive surgery is the surgical approach of choice for the management of numerous benign and malignant gynaecological conditions of uterus that has come up in the last 2-3 decades. Although their superiority has been assessed objectively over traditional method. To qualitate this Technicity Index (TI) has been introduced which is dened as number of minimally invasive hysterectomies (Vaginal Hysterectomy, Laparoscopic Assisted Vaginal Hysterectomy, Robotic Hysterectomy, Laparoscopic Hysterectomy) divided by total number of hysterectomy cases over a given period of time. Method : Retrospective study of 1411 patients who underwent hysterectomy over a duration of 6 years in a suburban tertiary care centre were included in the study.For the purpose of evaluation of Technicity Index(TI) only 1347 hysterectomies were included excluding 64 hysterectomies which were done for obstetric indications. Data regarding age, parity, indication for hysterectomy and route of hysterectomy was collected and analyzed. Result: Out of 1347 hysterectomies 25 were performed laparoscopically (1.85%), 700 were performed vaginally (51.96%) and 622 were performed by abdominal route (46.17%). The average TI was 55% and it ranged from as low as 46.9% to as high as 64.5% as the trend changed over the years. Conclusion: Quality of care is determined by duration of surgery, length of stay, rate of complications, quality of life. There have been many studies afrming the advantages of vaginal and laparoscopic hysterectomies over the traditional abdominal route. Complications like secondary wound infections are higher and are also associated with poor cosmetic results. Technicity index is a novel method of objective assessment of the difference between various health care indicators and this practice helps as a quality indicator and will improve the health care of the patients.