Background: Obstetric emergencies can occur suddenly and unexpectedly. Obstetrics is unique in that there are two patients to consider and care for, a mother and a baby or fetus. Identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness can reduce the incidence of obstetric emergencies. Present study was carried out to know the incidence, nature and outcome of obstetric emergencies.Methods: Retrospective study of obstetric emergencies admitted to Obstetrics and Gynaecology department of Indira Gandhi Institute of Medical science, Patna from March 2015 to September 2017.Results: The common clinical presentation was Ectopic Pregnancy (19.64%), Heart Disease (16.64%), Abortion (13.69%), Severe Anaemia (16.66%), Purpureal Sepsis (9.52%), Sever pregnancy induced hypertension (3.57%), Eclampsia/ HELLP Syndrome (2.38%), Multiple Pregnancy (1.19%) Malignancy Disorder with Pregnancy (2.97%) and HIV in pregnancy (0.59%). Intervention done include Dilation and evacuation (13.69%), Caesarean section (28.57%), Vaginal delivery (22.62%), Caesarean Hysterectomy (2.38%), Exploratory Laparotomy (20.83%) and conservative management in (11.90%) of patients. Maternal outcome include shock due to rupture ectopic and post-partum (16.68%), Blood Transfusion done in (27.99%), Septicaemia (15.48%), ICU admission (8.92%), HDU (12.5%), Pulmonary oedema (6.54%), DIC (4.16%), CCF (3.57%), Ventilatory Support (1.78%) and Maternal Mortality (2.38%). Fatal outcome includes live birth (58.8%), NICU Admission (27.45%), Ventilatory Support (7.84%) and Neonatal mortality (5.88%).Conclusions: High risk pregnancy identification and proper antenatal, intranatal and postnatal care will reduce the incidence of obstetrical emergencies. Peripheral health care system need to be strengthen and early referral need to be implemented for better maternal and fetal outcome.

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BackgroundHypovitaminosis D has been linked with poor semen parameters and endocrinological factors in male infertility. This study aimed to analyze the association of serum vitamin D levels and reproductive hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), and total testosterone (TT) with the semen parameters in a cohort of infertile men. MethodologyIn this study, 224 infertile men (aged 18-45 years) were recruited after applying inclusion and exclusion criteria. Semen analysis was performed as per the 2010 World Health Organization (WHO) criteria. The patients were divided into two groups on the basis of semen parameters: normozoospermic men and men with one or more altered semen parameters as per the WHO 2010 guidelines for all the analysis. Vitamin D and hormone levels were evaluated by quantitative competitive immunoassay by chemiluminescent microparticle immunoassay technology with flexible assay protocols (Architect, Abbott Diagnostics, Lake Forest, IL, USA). The patients were further divided into three groups on the basis of vitamin D levels: Sufficient (>20 ng/mL), insufficient (12-20 ng/mL), and deficient (<12 ng/mL). These groups were compared for different semen and hormonal parameters. ResultsOut of the 224 infertile men included, 124 were normozoospermic while 100 patients had one or more altered semen parameters. The median age of the participants was 30 years (minimum = 18 years, maximum = 45 years). The serum vitamin D and TT levels were significantly lower (p < 0.0001) and FSH (p = 0.001) and LH levels (p < 0.0001) were significantly higher in those with one or more altered semen parameters compared to the normozoospermic men. The sperm concentration, total motility, linear progressive motility, percentage normal morphology, and serum TT levels were significantly lower in the patients with serum vitamin D levels of <12 ng/mL in both the normozoospermic men and those with one or more altered semen parameters compared to patients with higher vitamin D levels. Semen parameters such as sperm concentration, total motility, linear progressive motility, and morphology were positively correlated with the levels of serum vitamin D and TT. ConclusionsVitamin D deficiency was examined in a large proportion of infertile men. Serum vitamin D and TT levels were positively associated with semen parameters evident from lower levels of vitamin D and TT in men with altered semen parameters compared to normozoospermic men. However, further comprehensive studies with larger sample sizes should be conducted to further validate the role of vitamin D in male infertility by checking the effect of vitamin D supplementation on semen parameters.