INTRODUCTIONToday there is an increased trend in the incidence of caesarean section (CS) rate worldwide particularly in middle-and high income countries, even with the lack of evidence supporting considerable maternal and perinatal benefits with CS rates higher than a certain threshold.The ideal CS rate should be between 10-15% as WHO recommended and was an accepted norm until 2014. 1Although CS is a life saving procedure for both mother and baby, the incidence of neonatal mortality and morbidity did not decrease with the increase in CS rates.The following reasons have been designated for the rise of CS rates include fear of medico-legal issues, increasing maternal request, increasing malpractice pressure, convenience of scheduled deliveries as well as economic, cultural and organizational factors.However, ICMR task force study stated after considering data from 30 teaching institutions that the most frequent ABSTRACT Background: Today, there is an increased trend in the incidence of caesarean section (CS) rate worldwide particularly in India, even with the lack of evidence supporting considerable maternal and perinatal benefits with higher CS rates. The main objective of our study was to find the incidence of CS rate, auditing the data on the basis of modified Robson criteria, factors responsible for the most common group, to know the changing trends of CS and finally put forth the strategies to reduce CS rate. Methods: This is a retrospective study of 472 CS cases carried out in a tertiary care hospital during the year 2016. All the cases were grouped according to the modified Robson criteria and the data was analyzed. The data were grouped into 3 different slots of 4 months each (FF = first four months; MF = middle four months and LF = last four months of the year 2016). Results: A significant increasing trend was observed in the groups of 2B and 5C where as a significant decreasing trend was noticed in 6C and 7C. The most common indications for caesarean delivery were cephalo-pelvic disproportion (CPD) (28%) and fetal distress (22%) in group 1 whereas in group 2A CPD, fetal distress and failed induction were found to be 12%, 24% and 30% respectively. Conclusions: The change in trend has been noticed in the last few months particularly in 2B and 5C groups suggesting that there is a change in the attitude of obstetricians in conducting caesarean deliveries before the onset of labour rather than performing CS after the onset of labour. Targeting 2B along with 5C would help our efforts in reducing the CS rate.

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INTRODUCTIONAsymptomatic bacteriuria (ASB) is a condition in which urine culture reveals a significant growth of pathogenic bacteria i.e. greater than 105 bacteria/mL without the presence of symptoms related to urinary tract infection (UTI).1 The pregnant women are more commonly affected than non-pregnant women due to various morphological, physiological changes and urinary stasis that occur during pregnancy due to the effect of progesterone. 2 The prevalence of ASB in pregnant women varies from 4% to 23.9% globally and the higher prevalence is attributed to lack of personal and environmental hygiene, socio-economic status, parity and ABSTRACT Background: The pregnant women are more commonly affected with asymptomatic bacteriuria (ASB) than nonpregnant women and its progression could lead to adverse maternal and perinatal outcomes. The study was designed with an aim to know the prevalence of ASB and its effects on maternal and perinatal outcome. Methods: In this prospective study, 300 antenatal women attending Anil Neerukonda Hospital were screened for ASB. Urine culture was performed using standardized Kirby-Bauer disc diffusion method on blood agar, Mac Conkey's agar for antibiotic sensitivity testing. The screened antenatal women were divided into two subgroups viz. asymptomatic bacteriuria positive (Group I) and asymptomatic bacteriuria negative (Group II) depending on the culture study and were followed till delivery for maternal and perinatal outcomes. Results: The prevalence of ASB was 11.33%. Out of 34 cases of ASB positive, 8 cases (23.5%) were delivered with birth weight <2500 grams as compared to 11 cases (4.1%) in unexposed cases (RR 5.68, 95% CI; 2.46-13.15; p<0.05). Preterm low birth was noticed in 5 (14.7%) cases of ASB positive pregnant women with compared to unexposed cases (RR 1.5, 95% CI; 0.61-3.65, p=0.36). Regarding maternal outcomes, premature labour was observed in 8 cases (23.5%) of ASB exposed women whereas 22 (8.3%) in non-exposed cases (RR 2.84, 95% CI; p=0.004). A significant number of women have developed hypertension (17.6%) and preeclampsia (8.8%) in ASB positive cases as compared to ASB negative cases (4.9% and 2.3% respectively). Conclusions: The prevalence of ASB was 11.33% in the present study. As one third of the cases were identified in early and late trimesters, regular and trimester wise screening need to be incorporated in routine antenatal screening for safe motherhood and new born health.

BACKGROUND IUGR may be due to condition in the foetal environment (e.g. chronic deficiency in oxygen or nutrition or both) or problem intrinsic to the foetus. So, we can prevent only further asphyxia by giving a good environment in already compromised foetus; that can be possible only by early assessing the foetus using the Biophysical profile score or Doppler velocity ratio of the umbilical artery or middle cerebral artery. So, this study will be helpful for those physicians where other investigations as Doppler velocimetry is not available and make plan to progress the pregnancy or deliver the baby.The aim of this study is to know the incidence of perinatal asphyxia as compared to other neonatal complications in preterm at or above 34 weeks Intrauterine Growth Restricted (IUGR) neonates in relation to abnormal BPP in mother.

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