OBJECTIVES: To compare and analyse in each group- delivery complications like postpartum haemorrhage, obstetric anal sphincter injury at 40-40+6 Week of Gestation. To compare and analyse in each group- perinatal outcomes, mainly perinatal mortality and special care unit admission. METHODS: This prospective comparative observational study was conducted in the Department of Gynaecology & Obstetrics, R. G. Kar Medical College and Hospital. For my study I had taken a total of 276 mothers whom I had subdivided into 2 groups. Group Ahad 138 mothers who had induction of labour (I) by some method. Remaining 138 mothers were allocated to Group B who had only watchful expectancy with monitoring and labeed as expectant management group(EM). RESULT: In group-A (I), 5(3.6%) patients had instrumental delivery in comparison to group B(EM) which had 15(10.9%) of instrumental delivery. LSCS was also higher in group B i.e 36(26.1%) as compared to group A i.e 25(18.1%). 108(78.3%) mothers had vaginal delivery who were induced whereas 87(63.0%) had vaginal delivery in expectant management group. Therefore, induction group had better outcome in terms of mode of delivery.It was also statistically signicant (p=0.0098). The distribution on the basis of APGAR score at 5 minutes of babies in between two groups was signicant. CONCLUSION: Elective induction at 40+ weeks is associated with a lower rate of caesarean delivery and does not increase the risk of major complications for newborns and can be offered to mothers having low risk and crossed their expected date of delivery.The ACOG says elective induction at 40+ weeks is a reasonable option for healthy women. Induction of labour at 40+ weeks should not be routine for women but it is important to counsel them and let them decide whether they want to be induced and when.

Background: Ectopic pregnancy (EP) is the single most important cause of maternal morbidity and mortality in the first trimester and its rising trend throws a great challenge to the obstetrician and gynecologist due to its varied presentation. Aim: To study the incidence, clinical trends, risk factors and surgical management of ectopic pregnancy in a tertiary care hospital. Materials and methods: Retrospective study conducted among the diagnosed cases of ectopic pregnancies admitted during a period of 3 years and a total of 474 cases were studied. Data collected from BHT, Labor ward registers, Gynae ward registrars, Operation Theatre registers, Intensive care unit (ICU) and high dependency units (HDU) records. All the parameters were tabulated and analyzed after data entry. Results: Peak age of incidence were among 26-30 years (32.27%), more common in multigravida (74.69%), commonly presented at gestational age between 6-8 weeks (50.42%) risk factors associated with 73.18% of cases. Most commonly presented with lower abdominal pain (75.31%) followed by short h/o amenorrhea (68.35%). Classical triad presents in 37.97% of cases. Clinically extreme pallor and hemodynamically shock stage presented in 26.58% and 33.33% cases respectively. The commonest site of affection was Ampulla of the tube (50.84%) and most common operation done was Salpingectomy (83.54%). There was no mortality. Conclusions: Early diagnosis and proper management becomes the key of success. High degree of suspicion, identification of risk factors, availability of modern investigations and timely intervention will definitely help to reduce the morbidity and mortality associated with EP.

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