BACKGROUND The incidence varies considerably from 1-14%, depending upon ethnicity, selection criteria and diagnostic tests performed. GDM affects the index pregnancy as well as two generations, mother and her child. Short-term intensive care in pregnancy, early detection and timely management will improve the good pregnancy outcome. The objectives of the present study are 1. to evaluate incidence of GDM in present tertiary care centre, Southern Maharashtra population 2. to evaluate maternal, foetal and neonatal complications; and 3. to evaluate risk factors for GDM.

This is a prospective randomized case control study to evaluate the role of 17 α hydroxyprogesterone caproate (17OHPC) in the prevention of preterm labor in high risk asymptomatic patients with a history of preterm delivery. METHODS: The study included 100 patients with a singleton pregnancy and having a prior preterm birth. They were divided in 2 groups, group I (treatment group) included 50 asymptomatic patients who were given 17OHPC injections starting from 18-24 weeks till 36 weeks and group II (control group) included 50 patients who did not receive any treatment. RESULTS: The incidence of preterm delivery was found to be 6.6%. The median gestational age at delivery was 36 weeks in group I and 34W5D in controls. 50% cases in group I and 80% of controls delivered prematurely in the group with a prior preterm birth between 20-28 weeks. Conclusion In patients who had a prior history of a preterm delivery the recurrence of a preterm birth was less in the treated group as compared to controls. The median gestational age at delivery was significantly higher in 17OHPC treated patients with history of earliest prior preterm delivery at 20-28 weeks.

AIM:The aim of this study was to compare the efficacy of extra amniotic Foleys catheter and intra cervical PGE2 gel in cervical ripening for the successful induction of labor. STUDY DESIGN: A randomized, prospective study was conducted in the Dept. of OBGY, KIMS, Karad from May 2012 to May 2014. 140 patients at term with a Bishop's score <6 with various indications for induction were randomly allocated to receive (70 pts) extra amniotic Foleys catheter or PGE2 gel (70 pts). After 6 h post induction, Bishop's score was noted labor was augmented if required. Statistical analysis was done using Chi square test and t test. RESULT: The groups were compared with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed no significant change in the Bishop's score for primigravida cases (P value-0.6) but for multigravida cases increment in Bishop's score was significantly more for PGE2 group (P value-0.048). There was no significant difference in the side effects For primigravida cases there was no significant difference in cesarean section rate for both groups but in multigravida cases cesarean section rate significantly more in Foleys group (P value-0.049).There was no significant difference in the induction to delivery interval in both groups for primigravida cases, but for multigravida cases duration was significantly less in PGE2 group (P value-0.047). APGAR scores and NICU admissions showed no difference between the two groups. Cost of induction was significantly less for Foleys catheter than PGE2 gel. CONCLUSION: This study shows that both Foleys Catheter and PGE2 gel were equally effective in pre induction cervical ripening in primigravida cases but for multigravida cases PGE2 gel was more effective than Foleys catheter for pre induction cervical ripening. KEYWORDS: Cervical ripening, PGE2, Foleys catheter. INTRODUCTION:Cervical ripening refers to a process of preparing the cervix for induction of labor by promoting effacement and dilatation as measured by Bishop's score. The success of labor induction depends on the cervical status at the time of induction. It is generally predicted that the patients with a poor Bishop's score <3 have unacceptably higher rates of failure of induction. It was also shown that a low Bishop's score is associated with increased rates of cesarean sections, maternal fever and fetal asphyxia. To decrease the induction failure, cervical ripening by any methods is the answer.The purpose of this study was to compare the efficacy of extra amniotic Foleys catheter with PGE2 gel for pre-induction cervical ripening. The induction delivery interval, maternal and fetal outcomes and the need for augmentation of labor in or these two groups were also compared.

Heterotopic pregnancy is defined as the simultaneous gestation at two or more implantation sites. It is a rare clinical condition and can be life threatening due to the risk of rupture of the ectopic pregnancy. Clinicians and sonographers tend to be lulled into a false sense of security when an intrauterine gestation sac is seen. This results in inadequate inspection of the adnexa and remaining structures during ultrasonography. Every gynaecologist treating a woman of reproductive age group should consider the suspicion of heterotopic pregnancy. Even in the absence of any known risk factor, it can lead to significant morbidity and mortality. Prompt diagnosis and treatment will help in continuing the intrauterine pregnancy till term. We report a case of a 36 year third gravida who presented with heterotopic pregnancy on ultrasonography after taking clomifene citrate for two cycles. Patient was posted for laparotomy and unilateral salpingectomy was performed.