Introduction Postpartum hemorrhage is a leading cause of maternal morbidity and mortality. Traditionally, visual method with variations in accuracy is followed, because it is quick, simple and noninvasive. To rely on this method accuracy is of vital importance. This study was aimed to improve accuracy of visual estimation of blood loss during vaginal delivery by standardizing (using similar sized mops and a fixed container) and correlating with hematocrit changes. Methods design A descriptive study. Sample size 250 women. Single fixed collecting container and similar sized mops were used in the third stage of labor. Blood was drained into the container and was visually calibrated by a single trained observer. The soaking characteristics of the mops were used to estimate total blood loss. Blood spillage on delivery table, garments and floor were approximately assessed. Total blood loss was calculated from the above three sources. Hemoglobin and hematocrit measurements were done at the time of admission and, at 24 and 72 hours postpartum and its correlation was done with blood loss. Analysis By paired and unpaired ‘t’ test. Results 250 out of 269 women completed the study. Incidence of PPH (> 500 ml) was 11.2%. The estimated blood loss correlated well with the hemoglobin and hematocrit changes postpartum. Conclusion Standardized visual method (fixed container and mops) with trained observer improves the accuracy of estimation. This may assist clinicians to accurately estimate blood loss thus preventing hemorrhage related complications.

Ureteral endometriosis is a rare disease affecting women of childbearing age, which presents with nonspecific symptoms and may lead to severe morbidity. The ureters can be involved either extrinsically and/or intrinsically by endometriosis. In this study we have retrospectively assessed the patients presenting to us with ureteral endometriosis. Materials and Methods: Between July 2009 and December 2019, (17) women of childbearing age presented to the urological services of the hospital with complaints of lower abdominal pain, dysmenorrhea, dysuria and a range of other symptoms. Results: Pain in lower abdomen was the most common symptom and was cyclical in the majority of the patients. Only 2 patients had undergone surgery (diagnostic laparoscopy) previously for pain in abdomen and normal ultrasonography. Conclusions: Ureteric endometriosis is rare but a cause of severe morbidity in those that have deep infiltrating endometriosis. Can lead to ureteric obstruction and at times loss of function. An index of suspicion in women in child bearing age is important. Hormonal manipulation along with surgical intervention is beneficial in most patients.

Introduction The present case series was an attempt to find out cotton (umbilical) tape usefulness as suture material for cervical encerclage as it is presterilized, easily visible and economical. Methods Objective To determine utility of cotton tape as suture material for cervical cerclage. Study design: A case series. Place KLES Hospital and District Hospital, Belgaum. Period 1997 to 2001. Inclusion criteria Singleton pregnancy, gestational age by USG (14-26 weeks), H/o 2nd trimester abortions, H/o Pre-term labor, elective cerclage. Exclusion criteria Medical diseases, multiple pregnancy, emergency encerclage, fetal anomalies by USG, not willing to provide consent. Outcome Gestational age at delivery, fetal survival, morbidity [white discharge per vagina (PV), cervical dystocia, puerperal pyrexia]. Intervention Cerclage with cotton tape. Technique Modified Mc Donald's: The suture is commenced from the posterior surface of the cervix and knot is put in the posterior surface. Results 89.3% (25 women) had term deliveries, i.e. 37 to 40 weeks, 7.1% (2 women) had spontaneous delivery at 36 weeks and one women (3.6%) had pre-term delivery at 30 weeks with the fetal survival was 96.4%. Conclusion The present case series proves that the simple economical cotton (umbilical) tape is effective as a suture material for cervical encerclage. However a larger randomized trial can confirm these findings.

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