ABSTRACT:The previous two or three induced -were spontaneous abortion will carry a risk of preterm, ectopic pregnancy. This is to study is to evaluate the outcome of pregnancy with history of previous abortion. MATERIAL AND METHODS: This study was conducted for one and half year period in Regional Institute of Medical Sciences, Imphal, Manipur. RESULTS: We observed that majority of the women in the study fell in 25 to 35 years of age. 116 (71.9%) women with history of induced abortion were aged between 25 to 30 years of age. 52(73.3%) women with history of spontaneous abortions were less than 30 years of age. There were only 7(9.7%) women in the spontaneous abortion group who were above 35 years of age. CONCLUSION: We concluded that women with previous history of two or three induced abortions were at risk of preterm birth, very preterm birth and low birth weight babies in the subsequent pregnancies. The risk of caesarean was found to be increased in women with previous two or three spontaneous abortions exposing the women to the morbidity associated with the C-section.

INTRODUCTIONCervical insufficiency is a well-known cause of second trimester pregnancy loss and is defined as the failure of the cervix to retain the foetus in utero till term due to a functional or structural defect of the cervix. 1 It is characterized by painless dilatation and effacement of the cervix, usually in the second trimester of the pregnancy, leading to bulging of foetal membranes through the uterine cervix and vagina, and, in severe cases through the external genitalia with resultant premature rupture of membranes and often, a pre-viable delivery.2 It has been estimated that cervical incompetence is responsible for 0.1-0.2% of all spontaneous abortions, contributes to 16-20% of all second trimester pregnancy losses, 3 8-15% among women with prior history of recurrent spontaneous abortions 4 and 10% of preterm deliveries. 5Cervical cerclage has been a common practice in obstetrics ever since it was first described by Shirodkar, ABSTRACTBackground: The objective was to evaluate the outcome of late second trimester emergency cerclage in patients with advanced cervical dilatation with bulging membranes. Methods: Setting: department of obstetrics and gynaecology, PSG Institute of medical sciences & research, Coimbatore, Tamil Nadu, India. This is a retrospective study of case files of patients who underwent emergency late second trimester cerclage for advanced cervical dilatation with bulging membranes between January 2009 to January 2014. McDonald's technique was used in all the cases. Results: Altogether, 7 patients (100%) underwent late second trimester emergency cerclage between 20-28 weeks of gestational age, out of which three patients (42.86%) had term deliveries (>37w), and 3 patients (42.86 %) carried on their pregnancies to more than 32 weeks resulting in healthy live born babies. Two of them delivered by normal vaginal delivery, 4 underwent LSCS, and one patient had severe abdominal pain with bleeding and draining per vaginum after 3 days of cerclage, in view of which the stitch was removed. Subsequently, the patient expelled a live foetus weighing 620gms, which died in the Neonatal Intensive Care Unit (NICU) after 3 hours. This procedure prolonged the duration of pregnancy in all patients with a mean duration of 70.4 days. The mean gestational age at the time of delivery was 34.33 weeks. The mean birth weight was 2.18 kg and ranged between 1.97 to 2.64 kg. The mean APGAR at one minute was 8/10 and the mean duration of stay in NICU was 1.66 days. All the new-born babies were healthy at the time of discharge. The live birth rate following emergency late second trimester cerclage in this series was 85.75%. Conclusion: Favourable neonatal outcome can be accomplished in patients with cervical incompetence in the second trimester of pregnancy following emergency cervical suturing, even if performed when the membranes are bulging through the cervix.

BACKGROUNDPregnancy greatly increases demand for metabolic fuels that are needed for growth and development of the foetus and its support structures. The major change in energy expenditure and in the accumulation of fat occurs at different times during pregnancy. Altered metabolic and hormonal status of the body in pregnancy leads to changes in lipid profile. An abnormal lipid profile is known to be strongly associated with atherosclerotic cardiovascular diseases and has a direct effect on endothelial dysfunction. Abnormal lipid metabolism seems important in the pathogenesis of Pregnancy Induced Hypertension (PIH). The association of serum lipid profile with gestational proteinuric hypertension is highly suggested to reflect some new diagnostic tools.This study was done to investigate the effect of pregnancy on lipid profile changes during 10 to 16 weeks of pregnancy. MATERIALS AND METHODSA total of 497 pregnant women between the age group of 17 and 43 years were enrolled after getting written informed consents from the patients. Patients with diabetes and ultrasound diagnosed foetal congenital anomaly were excluded. Data were computerised and analysed. RESULTSMean (SD) triglyceride and total cholesterol levels were 189.9 (36.85) and 209.9 (28.670) respectively. Mean (SD) of triglyceride values was visibly higher in PIH group than that of normotensive. CONCLUSIONConclusively, altered maternal serum lipid profile increases in susceptibility to the development of PIH and gestational proteinuric hypertension and other foetal diseases induced preterm birth and intrauterine growth restriction. Therefore, lipid profile estimation and monitoring should be made a part of routine investigation during antenatal period. Further studies are needed to determine if certain women are at increased risk of cardiovascular, hypertensive diseases in later life because of effects on their lipid profile during pregnancy.