A balanced approach to EOH can prove to be lifesaving at times when conservative surgical modalities fail and interventional radiology is not immediately available. Our study highlights the place of extirpative surgery in modern obstetrics in the face of rising rates of cesarean section and multiple pregnancies particularly in urban settings in developing countries.

Separation of pubic symphysis during delivery is a rare complication resulting in considerable and prolonged morbidity for parturient women. The usual presentation is that of something giving way in the region of the symphysis pubis sometimes with an audible crack at the time of delivery. Unbearable pain on moving from side-to-side and on performing any weight-bearing activity (such as walking or climbing stairs) precludes ambulation in the immediate postpartum period. This could be accompanied by disruption of the sacroiliac joint, hemorrhage, or urine incontinence in severe cases. Radiography, ultrasound, and magnetic resonance imaging are the diagnostic modalities that aid confirmation of diagnosis. The magnitude of separation does not correlate well with the severity of symptoms. Treatment modalities range from conservative management (including analgesics, pelvic binders, transcutaneous nerve stimulation) and chiropractic management to orthopedic interventions such as external fixation or open reduction and internal fixation. Since postpartum pain is frequently dismissed as attributable to labor and childbirth, the diagnosis of pubic symphysis diastasis is often delayed and sometimes missed altogether. Since there is no consensus in the scientific literature on the definition, etiopathogenesis, and management of this rare complication, we attempted to review the literature on the subject and present a series of two cases.

Background:Pre-eclampsia is one of the leading causes of high rates of maternal and perinatal mortality and morbidity. Pathophysiology of pre-eclampsia is still obscure. Currently, there are no screening tests for pre-eclampsia that are reliable, valid, and economical. Parameters of oxidative stress could be early markers of endothelial dysfunction that predates clinical pre-eclampsia.Aim:This study was to study ceruloplasmin in nulliparous women as marker of oxidative stress and lipid profile to evaluate their value in prediction of pre-eclampsia.Materials and Methods:Prospective observational study. 306 nulliparous women had their serum lipid profile and ceruloplasmin levels measured at 14-16 weeks period of gestation as sample 1 and at 18-20 weeks as sample 2. All cases were followed up till the end of pregnancy for development of pre-eclampsia.Results:There was no statistically significant difference between the normals and pre-eclampsia cases at 14-16 week for all the oxidative stress parameters (P > 0.05), but at 18-20 week, there was statistically significant difference between the normals and pre-eclampsia cases in cholesterol and ceruloplasmin parameters (P < 0.05).Conclusion:Cholesterol and ceruloplasmin levels in second trimester (18-20 weeks) can predict the development of pre-eclampsia.

Mifepristone when given in bi-weekly doses was found to be safe, efficacious, and cost effective as compared to treatment with tranexemic acid and mefenemic acid for management of fibroid uterus.

Low BMD is not a disorder confined to postmenopausal women alone. It is widely prevalent in women above 40 years of age. Screening women above 40 in the absence of any high risk factors has the potential of nipping this silent killer in the bud.