Background: Labor induction is one of the common interventions in obstetric practice. Assessment of cervix has been used as a predictor of the successful vaginal delivery. The traditional method of predicting whether an induced labour will result in successful vaginal delivery is based on the pre induction favourability of cervix as assessed by the Bishop score. Now we used transvaginal sonography (TVS) as an objective method of assessment of cervical length to evaluate the role of the pre-induction transvaginal ultrasonographic (TVS) cervical length in predicting labour outcome and comparing it to the Bishop score in patients undergoing induction of labour. Methods: This observational prospective study included 100 pregnant women in which induction of labour was performed at 37-42 weeks of gestation. Cervical length on transvaginal ultrasound and bishop score by digital examination is assessed prior to induction in cases according to standard protocol. Results: In our study though the sensitivity of the Bishop score in predicting the successful labour induction was higher (75.6%) compared with that of cervical length measured trans vaginally (69.35%). The specificity and positive predictive value for the cervical length (2.7 cm) was 77.78% and 91.49% compared with the Bishop score (4) 55.55% and 81.82% respectively. Conclusions: Bishop score and transvaginal cervical length both are good predictors of successful induction of labour. Transvaginal cervical length provides a better prediction of the likelihood of vaginal delivery within 24 hours of induction.

Background: This study was conducted to assess the relationship between mean uterine artery pulsatility index at 11+0 to 13+6 weeks and the development of hypertensive disorders of pregnancy.Methods: This prospective study was carried out on 320 pregnant women. In all subjects mean uterine artery PI was calculated at 11+0 to 13+6 weeks and association of value of uterine artery PI and development of hypertensive disorder of pregnancy were compared by receiver operative curve analysis.Results: The ROC curve analysis shows that at the cut-off value of 1.62, overall sensitivity, specificity, positive predictive value, and negative predictive value of PI for prediction of hypertensive disorder of pregnancy in our study was 82.1% (95% CI- 63.1-93.9%), 57.4% (95% CI- 51.5-63.2%), 15.7% (95% CI- 13.1-18.9%) and 97.1% (95% CI-93.7-98.7%) respectively. When we evaluate 11+0 to 13+6 weeks UtA PI value with hypertensive disorders of pregnancy and early-onset hypertensive disorders of pregnancy by AUC curve, we found that the area under curve was 0.73 (95% CI 0.64-0.81) and 0.78 (95% CI 0.69-0.86) respectively.Conclusions: Uterine artery pulsatility index at 11+0 to 13+6 weeks is significantly higher in women who develop hypertensive disorder in pregnancy. Our study also shows that 11±0 to13±6 weeks uterine artery pulsatility index was a more significant predictor of early onset pre-eclampsia. It is a simple, non-invasive, reliable test which can be performed as an adjunct to routine ultrasound examination to predict hypertensive disorders.

Background: Preeclampsia is a common medical complication in pregnancy in developing countries. It is one of the most common causes that lead to maternal and fetal morbidity and mortality. Incidence of preeclampsia in world is 3-5%.1 In India preeclampsia complicates 5-15% of pregnancies. As a result of these changes serial alteration in lipid profile, mainly increase in serum triglycerides, cholesterol occurs in pregnant women. Methods: After IEC clearance and taking informed written consent from the patients, present study was conducted at the Department of Obstetrics and Gynaecology in PDZH, RNT Medical College, Udaipur from December 2020 to June 2022. Results: Study result based on 100 pregnant women with pre-eclampsia (BP >140/90 mm of Hg) as cases and 100 normotensive pregnant women (BP <140/90 mm of Hg) as controls. Cases had significantly higher total cholesterol (219.21±63.13 vs. 176.24±31.33, P<.0001), significantly higher triglycerides (mg/dL) (208.35±79.32 vs. 166.41±29.6, P<.0001), significantly higher LDL (mg/dL) (133.7±39.81 vs. 103.96±18.38, P<.0001), and significantly lower HDL (mg/dL) (43.29±7.09 vs. 50.18±8.15, P<.0001) in comparison to control. Conclusions: Women with pre-eclampsia had significantly higher serum Cholesterol, LDL, TG and significantly lower HDL in comparison to healthy pregnant women. There was a significant increase in the serum Cholesterol, LDL, TG in patients from mild to severe pre-eclampsia.

Background: The objectives of antepartum fetal surveillance are to prevent fetal death and avoidance of unnecessary intervention. This study using NST as a tool for routine antepartum fetal surveillance is we will be trying to catch up those fetuses who might be at risk in womb and provide prompt intervention in otherwise considered normal pregnancies without any obvious high-risk factor thus giving the best outcome in mothers.Methods: The objective of this study was to evaluate the correlation of the non-stress test with fetal outcome in pregnancies from 37-42 weeks of gestation.  This was a prospective observational study at RNT Medical college Udaipur (Rajasthan) from November 2021 to March 2022. This study included 100 normal pregnant mothers from 37 weeks to 42 weeks who were subjected to NST.Results: The parameters of poor fetal outcome like apgar score <7 at 5 minutes had increased incidences in the non-reactive group.Conclusions: This study suggests that the NST was found to be a good predictor of the healthy foetus even in normal pregnancies between 37-42 weeks of gestation and the probability of an adverse outcome such as poor Apgar score increases with a non-reactive strip.

Background: Sustainable development goal 3 includes an ambitious target of reducing the global maternal mortality rate (MMR) to less than 70 per 100,000 births by 2030. Understanding the causes of and factors contributing to maternal deaths is critically important for development of interventions that reduce the global burden of maternal mortality and morbidity. The International classification of diseases-maternal mortality has proven to be easily applicable and helps clarify the cause of maternal death. Methods: Retrospective study of 100 maternal death cases was done in a tertiary medical centre of Rajasthan from December 2020 to November 2021 for determining the causes of maternal death and their classification according to ICD-MM. Results: A total of 100 maternal mortality cases were analyzed in this study for causes of death. Classification of causes of death according to WHO ICD-MM is represented in study results. Direct causes of maternal deaths were observed in 82 % cases whereas indirect causes were present in remaining 18%. Hypertensive disorders (29%), obstetric haemorrhage (27%) and pregnancy related infection (12%) constituted the major groups of direct cause of maternal deaths whereas systemic infections were the most common indirect cause (15%). During the study period, COVID-19 was attributable to 12 cases of maternal death.Conclusions: Hypertensive disorders (29%), obstetric haemorrhage (27%) and pregnancy related infection (12%) were the major causes of direct obstetric death and systemic infections (15%) was the most common cause of indirect obstetric death. All of these causes are preventable with targeted interventions.