Background:Assessment of foetal wellbeing is important, in timely diagnosis of foetalcompromise and management. Oligohydramnios is associated with increasedincidence of adverse perinatal outcomes like foetal distress, meconium stained liquor, lowAPGAR score, low birth weight, NICU admission, perinatal morbidity and mortality.Foetal biophysical profile is a well-established method of antepartumsurveillance. Classical biophysical profile needs two phase testing by ultrasound and external doppler monitor to record foetal heart rate, is more cumbersome, time consuming and expensive. The modified biophysical profile (MBPP) suggested by Nageotte et al combines non stress test (NST) as a short term marker of foetal status and the amniotic fluid index (AFI) as marker of long term placental function is easier to perform and less time consuming than classical biophysical profile. Objectives: 1) To assess the role of modified biophysical profile as a method ofantepartum foetalsurveillance test in predicting perinatal outcome in oligohydramnios cases. 2) To compare the morbidity and mortality with respect to each of the parameters ofmodified biophysical profile, that is NST and AFI individually. Methods:This study was a prospective clinical study which consisted of 60 pregnant women with oligohydramnios. The patients were evaluated with themodified biophysical profile consisting of NST recording for 20mins, followed byultrasound assessment of amniotic fluid volume, using four quadrant technique. Results:• When the Modified biophysical profile is normal, it gives reassurance that thefoetal status is good with good perinatal outcome. • When the MBPP is abnormal there is increased incidence of perinatalmorbidity as well as mortality.When considered individually, abnormal AFI was associated with increasedincidence of perinatal morbidity and abnormal NST was associated with increasedincidence of perinatal morbidity as well as perinatal mortality. Interpretation and conclusion:Modified biophysical profile is an effective method ofantepartum foetalsurveillance test in oligohydramnios in predicting perinatal outcome. Key words:Modified biophysical profile (MBPP), biophysical profile (BPP), non-stresstest (NST), amniotic fluid index (AFI), foetal heart rate (FHR), amniotic fluidvolume(AFV).I.

Background: The importance of fetal monitoring during labour has been realized since long. The stress of uterine contractions may affect the fetus adversely especially if the fetus is already compromised, when the placental reserves are suboptimal, or when cord undergoes compression as in those associated with diminished liquor amnii or iatrogenic uterine hyperstimulation due to injudicious use of oxytocin. Even a fetus which is apparently normal in the antenatal period may develop distress during labour. Hence fetal monitoring during antepartum and intrapartum periods is of vital importance for timely detection of fetal distress so that appropriate management may be offered. Methods: This study was a prospective observational study included 100 patients of more than 34 weeks period of gestation were divided into two groups. Patients in labour were analyzed on an Electronic Monitor. Delivery conducted was either by vaginal route, instrumental or by caesarean section depending upon the fetal heart rate tracings and their interpretations as per the case. At the time of delivery umbilical cord blood was taken for the pH analysis. All new born babies were seen by the paediatrician immediately after the delivery and 1 and 5 minute APGAR score assessed for the delivered baby. The various EFM Patterns obtained were compared with the neonatal status at birth using the parameters already mentioned. The false positives and false negatives if any were tabulated. Data so obtained was analyzed statistically thereafter. Statistical Package for Social Sciences (SPSS) Version 13.0 was used for the purpose of analysis. Results: Results revealed that among the 50 subjects of the case group, 7 subjects showed the absence of the beat to beat variability, 12 subjects showed early deceleration, 32 subjects showed late deceleration, and 6 subjects showed the presence of variable deceleration. No significant association of beat to beat variability, early and variable deceleration could be established with meconium staining/NICU admissions/low APGAR. A significant positive association between persistent late deceleration with MSL, APGAR <7 at 1 min, and Instrumental/LSCS delivery was seen. A significant positive association between any CTG abnormality and APGAR at 1 min, type of delivery, and meconium staining was seen. Conclusions: EFM should be used judiciously. Cardiotocography machines are certainly required in the labour room. Equally important is the proper interpretation of the CTG tracings so that unjustified caesarean sections can be minimized, at the same time picking up cases of fetal distress in time which is likely to improve fetal outcome.

Background: Childbirth has a profound influence in a women’s life. One factor that has been more consistently identified as influencing the women’s physical and psychological symptoms following childbirth is the mode of birth.  This study aims at figuring out on women’s satisfaction with their mode of delivery and what difficulties they faced in the immediate postnatal period accordingly.Methods: All women who delivered between the period 1st July 2019 to 1st August 2019 were interviewed with a pretested semi structured questionnaire on postnatal day two. Patient was asked how much they were satisfied with their mode of delivery, immediate postnatal adjustments like ambulation, holding the baby first time, initiation of breastfeeding and pain score following different modes of delivery. The data was analysed to find out which mode of delivery made women more comfortable in the immediate postnatal period.Results: A total 97.1% women were satisfied with the support they got from health care professionals during labour. But when compared, spontaneous vaginal delivery group were satisfied with their mode of delivery (P-value-0.0005 highly significant) than the rest. Women who had vaginal delivery were ahead of caesarean group in terms of ambulation, holding the baby, initiation of breastfeeding and were well adjusted in their postnatal period.Conclusions: Authors conclude that women in our study were more satisfied with spontaneous vaginal delivery than caesarean section which was reflected in their immediate postnatal adjustments. As obstetricians’ authors need to understand the empowering effects of the psychological experience of vaginal delivery. The benefits of this process can be maximized through good communication skills and emotional support for women, enhancing their confidence to deliver normally so that caesarean section is done only when really indicated.

The incidence of congenital uterine malformation is estimated to be 3-5% in general population. Abnormal fusion of Mullerian duct in embryonic life results in variety of malformations. Here, we report a case of successful pregnancy outcome in a Bicornuate bicollis uterus with communicating cavities that was initially diagnosed by USG. Clinically we found double cervix and by USG two horns. PPROM with non reassuring foetal heart rate later in pregnancy necessitated an emergency LSCS at 34Wks of gestation. The diagnosis was confirmed intra operatively by exteriorizing the uterus and noting the communicating cavities.