BACKGROUNDCultural practices and beliefs of newborn care are deep rooted in the community. Some of them are harmful and can endanger the life of a newborn. It is important to identify and educate about these harmful practices to reduce neonatal mortality. This study was conducted to assess the knowledge of mothers on current newborn care practices and to evaluate the impact of health education on the knowledge of mothers on newborn care practices in a tertiary hospital. MATERIALS AND METHODSThis study was undertaken on 476 postnatal mothers in Government General Hospital, Kakinada during September 2016 to December 2016. A pre-tested questionnaire was used to assess the knowledge on newborn care and cultural practices of these mothers. This is followed by health education on correct newborn care practices and post-test assessment of improvement in knowledge was done after one month. RESULTSKnowledge of the mothers is improved in each practice like colostrum feeding (87.6% vs. 98.7%), prelacteal feeds (68.4% vs. 92.4%), exclusive breast-feeding (62.4% vs. 87.5%), first bath (63.3% vs. 91%), substance application to cord (67.3% vs. 93.1%), oil massage (86.9% vs. 98%), oil instillation (68.7% vs. 88.8%), breast-feeding in maternal illness (61.2% vs. 89%), breast-feeding in sick baby (81% vs. 96%), kajal to eye (6% vs. 14%), gripe water (37.2% vs. 60%) and pacifier usage (43.5% vs. 79.8%) after health education intervention. Mean knowledge scores are improved from 7.3 (pre-test) to 9.8 (post-test). Paired t test was applied and p value is < 0.001, which is statistically significant. CONCLUSIONHealth education is a cost-effective intervention to bring out behaviour change to curtail harmful practices and to promote healthy newborn care practices in the society.

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BACKGROUNDGenitourinary fistulae are known complications of pelvic surgery and prolonged labour. Successful treatment outcomes hinge on detailed evaluation of the site of fistula, appropriate timing and technique of surgery.The aim of the study is to study the presentation, aetiology and evaluation of different treatment options. MATERIALS AND METHODSThis is longitudinal prospective study consisting of 30 cases of genitourinary fistulae. Analysis of aetiology and incidence of various types of genitourinary fistulae and diagnosis and management over a period of 1 and ½ years from September 2013 to April 2015. This study was carried out at Mahatma Gandhi Memorial (MGM) Hospital, Warangal, attached to Kakatiya Medical College. RESULTSOut of 30 cases, 20 (66.66%) have gynaecological cause of fistulae and 10 (33.33%) cases have obstetric cause of fistulae. Out of 20 gynaecological type of fistulae, vesicovaginal fistulae are 12 cases (60%), ureterovaginal fistulae are 6 cases (30%) and vesicovaginal + ureterovaginal fistulae are only 2 cases (10%). Out of 10 obstetric types of fistulae, vesicovaginal fistulae are seen in 7 cases (70%), vesicouterine fistulae are seen in 1 case (10%) and vesicovaginal + urethrovaginal fistulae are 2 cases (20%). In total 30 cases, 24 (80%) cases developed genitourinary fistulae during surgery, in 3 cases because of ruptured uterus and in 3 cases because of obstructed labour. Most common type of fistulae is vesicovaginal fistulae seen in 63.33% (19 cases), next most common type of fistulae is ureterovaginal fistulae seen in 20% (6 cases), combination of vesicovaginal fistulae + ureterovaginal fistulae is seen in 6.6% (2 cases), combination of vesicovaginal fistulae + urethrovaginal fistulae is seen in 6.6% (2 cases) and vesicouterine fistulae is 3.3% (1 case). Vesicovaginal fistulae causes complete incontinence of urine. Diagnosed mainly by cystoscopy, which detects site and size of fistulae near the trigone or not and number of fistula and associated ureterovaginal fistulae. Other investigation done by CT scan. All the cases are treated by transabdominal and transvesical route. For big fistulae, bivalve method repair done. Out of 19 vesicovaginal fistulae for 17 cases, surgery done in our hospital and 2 cases referred to the higher center.

BACKGROUNDEpidemiological data pertaining to maternal mortality is valuable in each set up to design interventional programs to favourably reduce the ratio. This study was done to evaluate the maternal mortality rate in our hospital, to assess the causes of maternal mortality. MATERIALS AND METHODSThis is a longitudinal prospective study. Study group: consisting of 50 cases of maternal deaths. Study period: 13 months i.e., from November 2016 to November 2017. This study was carried out at Government general hospital Kakinada attached to Rangaraya Medical College, Kakinada. RESULTSIn this study, 10% maternal deaths seen in 1 st trimester of pregnancy. 10% maternal deaths before delivery. 80% maternal deaths occurred after delivery. Among these, 60% maternal deaths after lower segment caesarean section. 20% maternal deaths after normal vaginal delivery. In this study, direct causes of maternal mortality 66%. Among these: preeclampsia -15 cases (30%), Haemorrhage -9 cases (18%), Infections -4 cases (8%). Indirect causes of maternal mortality 34%. In these Anaemia -4 cases (8%), Jaundice -4 cases (8%). 60% maternal deaths are referral cases. CONCLUSIONIn our hospital, maternal mortality rate is 437 per 100,000 live births. It is very high because, in this center most of the cases. About 60% are referral cases from surrounding area. Unbooked cases are 74%. Most of cases about 70% cases are from rural area. Among these, 80% maternal deaths occurred after delivery. 60% maternal deaths occurred after lower segment caesarean section. 20% maternal deaths occurred after vaginal delivery. In this study 66% maternal deaths occurred because of direct cause. Among these Preeclampsia (15) cases -30%, Haemorrhage (9) cases -18%, Infection (4) cases -8%. In our study indirect causes of maternal deaths 34%. Among these, anaemia (4) cases -8%, jaundice (4) cases -8%.

BACKGROUND Advanced maternal age generally signifies age after 35 years at the time of delivery. Maternal age is an important determinant of the outcome of pregnancy. Elderly women are at a high risk of several complications like abortion, ectopic pregnancy, preterm labour, hypertension, gestational diabetes, malpresentation and instrumental deliveries. Older the women, higher the fetal complications like Downs syndrome, preterm baby, low birth weight (LBW) babies and intrauterine growth restriction (IUGR). The purpose of this study was to assess the fetomaternal outcome in elderly pregnancy at a tertiary care centre. METHODS This study was a prospective hospital-based study of 100 elderly pregnant women aged 35 years and above admitted in OBG Department, Government General Hospital, Kakinada, Andhra Pradesh, from June 2020 to May 2021. The labor ward register and case records were used for all elderly gravida women admitted and delivered and details of these patients was recorded in the proforma. RESULTS In this study, 68 % were in 35 - 37 years, 32 % were in 38 - 40 years age group. 36 % were primigravida and 64 % were multigravida. 76 % women were housewives and 24 % women were employed. 32 % of women had history of previous abortions. Hypertensive disorders were observed in 42 % of patients, gestational diabetes was observed in 28 % of patients, antepartum haemorrhage was observed in 24 % of patients, IUGR was noted in 20 % of patients and preterm delivery was noted in 10 % of patients. 46 % of patients were delivered by vaginal route and 40 % of patients were delivered by caesarean section. 7.69 % were intrauterine devices (IUDs), 3.85 % had congenital anomalies. CONCLUSIONS Elderly women are at a high risk of developing several maternal and fetal complications. Many of these complications can be successfully managed with improved health services, pre-conceptional counselling and frequent antenatal visits. KEYWORDS Advanced Maternal Age, Maternal Complication, Caesarean, Preterm Delivery