Background: Hypothyroidism (HT) is associated with maternal and perinatal morbidity. Subclinical HT rather than overt occur in pregnancy, because overt HT causes infertility. Treatment of overt HT was beneficial in reducing the fetal and maternal complications, Usefulness of correcting subclinical hypothyroidism was doubtful, hence Universal screening of pregnant women was not recommended. Methods: Cross sectional study, conducted in the department of obstetrics and gynecology, Government Medical College, Thrissur, Kerala, India. 50 consecutive cases of subclinical hypothyroidism in pregnancy were analyzed for Thyroid function, antenatal, natal, postnatal complications. Perinatal complications, including neonatal hypothyroidism also noted. Statistical analysis done using computer software Epi info3.4. Data expressed in its frequency and percentage, continuous data in mean. Results: All women in the study group received levothyroxine during pregnancy from time of diagnosis. At the time of delivery 84% women were euthyroid and 16% hypothyroid. Complications like anemia 36%, abruption 4%, and postpartum hemorrhage 6% showed a statistically significant association, while pre-eclampsia 20%, preterm labor 22% had no statistically significant association. Comparing the women who are euthyroid as a result of levothyroxine supplementation to women inadequately treated, complications like anemia (33% versus 50%, p value 0.042), abruption (0% versus 4%, p value0.023), PPH (2% versus 6%, p value 0.014) were significantly less in well controlled. Conclusions: Significant association was noted between inadequately treated hypothyroidism and maternal complications like anaemia, placental abruption, placenta previa, PPH, preterm delivery, and caesarean section rate for foetal distress. Universal screening of pregnant women for thyroid status is recommended.

BACKGROUND Preterm premature rupture of membranes (PPROM) occurs in less than 3% of deliveries and contributes to one third of preterm deliveries and is a major contributor for obstetric morbidity and adverse perinatal outcome. PPROM is multifactorial in aetiology with several risk factors postulated including maternal infections. The obstetric outcome is also dependent on these risk factors. MATERIALS AND METHODS Settings and Design-This was a prospective analytical study conducted in Department of OB/GYN, Government Medical College, Thrissur over a period of two years. 160 cases of singleton pregnancies presenting as PPROM between gestational age of 24 to 36 weeks were analysed for their sociodemographic factors and followed up for their obstetric outcome including latent period, mode of delivery, obstetric complications and perinatal outcome. RESULTS On analysing the complications, it was found that 11.25% of patients developed chorioamnionitis as a consequence of PPROM compared to an incidence of 3.1% (166 out of 5205) patients out of the total deliveries (chi square 30.4, p value 0.0000). 7.5% had antepartum haemorrhage in which two third (67%) were detected to have placenta praevia on ultrasound while one third (33%) were diagnosed with abruptio placenta compared to 3.86% of APH in the total population (201 out of 5205) (Chi square 5.38, p value 0.02). Cord prolapse occurred in 1 patient (0.6%) with PPROM, in which baby was stillborn (chi square 1.94, p value 0.16) when compared to 2 cases of cord prolapse in the total number of patients delivered (.04%). 13.1% of patients in this study developed postpartum haemorrhage with 4.1% requiring blood transfusion compared to 5.15% of PPH in the total population (268 out of 5205) (chi square 19.3, p value 0.00001). CONCLUSION PPROM is a significant contributor of poor obstetric outcome. Many of the contributing factors of PPROM if detected sufficiently early and appropriately treated may not only decrease the onset of PPROM, but also have the potential to reduce the complications.

BACKGROUNDA study to analyse Anaesthesiologist's preference of Whitacre and Quincke needles for lumbar subarachnoid block. Whitacre needle is not routinely used in spite of its advantages like decreased incidence of post-dural puncture headache because of its unfamiliarity among Anaesthesiologists and its low ease of availability.

BACKGROUNDThe aim of this study is to analyse the acceptance of the rectal route of Diclofenac for postoperative analgesia in post caesarean patients as second dose analgesia after they had been given pre-emptive analgesia with rectal diclofenac. The rectal route of drug administration has many advantages over other alternate routes. Rectal route may not be accepted by most individuals in spite of its well established advantages. In this study, all patients were given prior information regarding the advantages of rectal diclofenac. There are only a few studies regarding the acceptance of the rectal route of drug administration. Awareness of the reasons for not preferring this route may help improve the acceptance of rectal drug delivery in the future.