Background: Ectopic gestation is a gynaecological emergency which culminates in pregnancy loss and causes significant maternal morbidity, mortality besides jeopardizing future conception. The study discusses the incidence, risk factors, symptomatology and management of ectopic pregnancy in a tertiary care teaching hospital.Methods: This was a prospective study of 45 cases of ectopic pregnancies at a tertiary care teaching hospital from January 2012 to December 2013. Information was collected in a structured proforma, tabulated and descriptive analysis was carried out.Results: The incidence of ectopic pregnancy was 1.17%. Majority of the patients (80%) belonged to 20-30 yrs age group. Second gravidas predominated (42.2%). Fallopian tube was the most common site (95.5%). Rudimentary horn ectopic accounted for 4.65%. Previous abdominopelvic surgery (31.1%), IUCD usage (22.2%), PID (20%), abortions (20%), tubectomy (15.5%) were the principal risk factors. 42% of the patients had no risk factor. The triad of amenorrhea, bleeding per vaginum and abdominal pain was seen in 51.1% of cases. Ultrasound, UPT, β-hCG estimation were the diagnostic tools. Ruptured ectopic pregnancy accounted for 64.4%. Nearly 95.5% of patients underwent surgery; salpingectomy (76%). Methotrexate was successful in 4.44%. There was no maternal mortality.Conclusions: Mostly diagnosis, prompt surgical or medical management is cornerstone of treatment. Primary prevention such as improved access to family planning services, sex education, treatment of STI, PID, surgical asepsis  and haemostasis, implementing legislation for dispensing MTP drugs ameliorate risk factors and hence reduce ectopic pregnancy.

Background: Indian women have an eleven fold increased risk of developing glucose intolerance during pregnancy compared to Caucasian women .Universal screening for GDM is essential in India. This study was undertaken to find out a single step procedure which serves both as a screening and a diagnostic tool. Methods: This study was carried out in a tertiary care teaching institute in Karnataka. 839 pregnant women with gestational age between 24-28 weeks were subjected to 50 gram OGCT and venous blood was drawn after 1 hour. These patients were requested to come after 72 hours on empty stomach for WHO-75 gram OGTT. Fasting and 2 hour blood samples after 75 gram of glucose were drawn. Results: Amongst the 839 pregnant women who underwent 50 gram OGCT, 136 (16.2%) women had one hour plasma glucose >140 mg/dl. Subsequent 75 gram OGTT revealed that only 43 (31.62%) of screen positive patients were diabetic.93 women who tested positive by 50 gram OGCT were false positive cases (10.58%). Prevalence of GDM in study population was 6.3 % (53/839). Screening OGCT missed 10 (15.87%) of gestational diabetes mellitus cases which were picked up by 75 gram WHO OGTT only. Conclusions: The diagnosis of Gestational Diabetes Mellitus by OGTT based on initial OGCT screening leaves 15.87% undiagnosed. The two step method of screening OGCT and diagnosing GDM with subsequent OGTT is tedious and not economical. Instead a single step WHO 75 gram fasting OGTT with 2 hour PPG ≥ 140 mg/dl is simple and precise.

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Background: Preterm birth (PTB) forms the prime etiology of mortality and morbidity in neonates worldwide. Our study compares serum epigenetic 548ai] and proteomic profiling [interleukin-6 (IL-6), alpha-fetoprotein (AFP)] in prediction of preterm birth. Materials and methods: Blood was drawn from 88 pregnant women at 19-26 weeks of gestation who were followed until delivery. The concentrations of miR-150-5p, miR-223-3p, miR-302b-3p, and miR-548ai (Real-time polymerase chain reaction-RT-PCR) were compared with IL-6 and AFP [enzyme-linked immunosorbent assay (ELISA)]. Results: Our study had 75 term and 13 preterm deliveries. A "p" value of 0.003 for birth weight and preterm delivery; statistically noteworthy was appreciated. Upregulation of miR-150-5p, miR-223-3p, miR-302b-3p was seen in preterm patients with p-value of 0.021, 0.060, and 0.062, respectively. The area under the ROC curve (AUC-ROC) analysis for miR-150-5p (0.739) showed 46.15% sensitivity with 100% specificity and positive predictive value (p-value = 0.0042). miR-302b-3p had the highest sensitivity and negative predictive value of 84.6 and 96.1%, respectively. miR-223-3p defined a 100% positive predictive value and specificity. miR-548ai had 69.23% sensitivity, 44% specificity and p-value = 0.6884 (AUC-ROC). The IL-6 and AFP levels were not significantly different between two delivery groups (p-value = 0.466 and 0.399). Conclusion: miR-150-5p is an effective epigenetic biomarker for prediction of preterm labor compared to IL-6 and AFP. miR-223-3p, miR 302b-3p levels are upregulated in preterm women.