Background: Episiotomy procedure enlarges the vaginal outlet to facilitate childbirth. Polyglactin 910 fast-absorbing sutures are widely used for the repair of episiotomy because of their rapid absorption and less inflammatory response. This study was designed for subjective assessment of perineal pain post-episiotomy repair, with Trusynth Fast® and Vicryl Rapide® polyglactin 910 fast-absorbing sutures. Method: This was a single-blind, randomized, prospective study conducted between January 7, 2021 and July 14, 2021 across two centers in India. Primiparous or multiparous women (18—40 years), who required episiotomy during vaginal delivery were included, and either Trusynth Fast® (n=47) or Vicryl Rapide® (n=49) suture was used for their episiotomy repair. The primary endpoint, perineal pain was assessed with visual analogue scale at all follow-up visits. The secondary endpoints, quantity of local anesthesia, number of sutures used, time to repair episiotomy, intraoperative suture handling, analgesics used, early and late wound complications, wound re-suturing, time to complete healing, presence of residual sutures, return to sexual activity, dyspareunia, and adverse events were also recorded. Results: The study showed no significant difference in perineal pain between the two groups at any visit. A statistically significant difference (p<0.05) in total score of episiotomy healing scale on day 2 (0.13±0.34 versus 0.35±0.56) and swelling on day 2 (8.51 versusversus 28.57%) was noted between Trusynth Fast® and Vicryl Rapide® group. Non-significant difference was observed between the groups regarding anesthesia, number of sutures, time to repair episiotomy, intraoperative suture handling, analgesics, puerperal fever, wound infection, dehiscence, hematoma, urinary incontinence, re-suturing, time to complete healing, return to sexual activity and dyspareunia. Conclusion: Trusynth Fast® suture is clinically equivalent to Vicryl Rapide® suture and can be used for episiotomy repair with minimal risk of perineal pain and wound complications. Clinical Trials Registry of India Registration: CTRI/2020/12/029925; Registered on December 18, 2020

Background: Episiotomy procedure enlarges the vaginal outlet to facilitate childbirth. Polyglactin 910 fast-absorbing sutures are widely used for the repair of episiotomy because of their rapid absorption and less inflammatory response. This study was designed for subjective assessment of perineal pain post-episiotomy repair, with Trusynth Fast® and Vicryl Rapide® polyglactin 910 fast-absorbing sutures. Method: This was a single-blind, randomized, prospective study conducted between January 7, 2021 and July 14, 2021 across two centers in India. Primiparous or multiparous women (18—40 years), who required episiotomy during vaginal delivery were included, and either Trusynth Fast® (n=47) or Vicryl Rapide® (n=49) suture was used for their episiotomy repair. The primary endpoint, perineal pain was assessed with visual analogue scale at all follow-up visits. The secondary endpoints, quantity of local anesthesia, number of sutures used, time to repair episiotomy, intraoperative suture handling, analgesics used, early and late wound complications, wound re-suturing, time to complete healing, presence of residual sutures, return to sexual activity, dyspareunia, and adverse events were also recorded. Results: The study showed no significant difference in perineal pain between the two groups at any visit. A statistically significant difference (p<0.05) in total score of episiotomy healing scale on day 2 (0.13±0.34 versus 0.35±0.56) and swelling on day 2 (8.51 versusversus 28.57%) was noted between Trusynth Fast® and Vicryl Rapide® group. Non-significant difference was observed between the groups regarding anesthesia, number of sutures, time to repair episiotomy, intraoperative suture handling, analgesics, puerperal fever, wound infection, dehiscence, hematoma, urinary incontinence, re-suturing, time to complete healing, return to sexual activity and dyspareunia. Conclusion: Trusynth Fast® suture is clinically equivalent to Vicryl Rapide® suture and can be used for episiotomy repair with minimal risk of perineal pain and wound complications. Clinical Trials Registry of India Registration: CTRI/2020/12/029925; Registered on December 18, 2020

BACKGROUND Hypertensive disorders of pregnancy are one of the important causes for adverse maternal and foetal outcome. A proper understanding of this medical disorder in pregnancy is essential to reduce the maternal and foetal complications associated with it. We wanted to analyse the incidence of hypertensive disorder complicating pregnancies among pregnant women attending antenatal care at Government Victoria Hospital, Visakhapatnam, and study the maternal and perinatal outcome in terms of morbidity and mortality among these women. METHODS It is a prospective and observational study. The study was performed among a total of 6411 pregnant women who have delivered at Government Victoria Hospital from July 2018 to June 2019. A total number of 431 pregnant women with hypertensive disorders complicating pregnancy were analyzed and the outcome of the hypertensive disorders in terms of maternal and perinatal morbidity and mortality were studied. Data was collected regarding antenatal care-booked and unbooked cases, age, parity, gestational age, mode of delivery and maternal complications. Perinatal outcome including birth weight, NICU admissions and perinatal deaths were recorded. Data was analysed and tabulated using SPSS version 24. RESULTS The total number of deliveries during this period was 6411 and 431 women had hypertension complicating pregnancy giving an incidence of 6.72%. Normal vaginal deliveries were seen in 187 cases (43.38%) and instrumental delivery in 17 cases (3.96%). The caesarian section rate was 52.66%. The number of cases with postpartum hemorrhage was 8 cases (1.86%). Placental abruption was in 4 cases (0.93%). Pulmonary oedema in 2 cases (0.46%), Thromboembolism in 1 case (0.23%), Postpartum cardiomyopathy in 1 case (0.23%) seen. There were two maternal deaths, one due to pulmonary embolism and one due to cardiomyopathy. The number of cases with birth weight less than 2 Kg were 74 cases (14.17%). Growth restriction was 25 cases (5.80%). NICU admission was required for 87 cases (20.19%). Early neonatal deaths occurred in 22 cases (5.10%). Number of still births in 8 cases (1.86%). Number of intrauterine deaths in 2 cases (0.46%). CONCLUSIONS Hypertension in pregnancy is associated with adverse maternal and perinatal outcome. Good antenatal care and early referral can reduce complications.

BACKGROUND This study was done to evaluate the changing trends in caesarean section over one-decade period and to determine as to whether increase in caesarean section rate is due to increase in antenatal surveillance or due to medically complicated pregnancies. MATERIALS AND METHODS The study was conducted in a 150 bedded government hospital, a maternity hospital affiliated to Andhra Medical Collage, Visakhapatnam, Andhra Pradesh. Data was collected retrospectively from database from 2008 to 2018. The CS rates and indications of primary and repeat caesarean sections (CS) were analysed among 6478 live births during 2018. CS rates have increased as it has become the procedure of choice in high risk pregnancies to prevent prenatal morbidity and mortality; this has become possible due to improved patient care, availability of effective antibiotics, blood transfusion services, safer anaesthesia, improved surgical technique and sophisticated neonatal care services. RESULTS As medically complicated pregnancies and antenatal surveillance have increased, there was an increase in caesarean section rate. Caesarean section rate increased from 21.88% in 2008 to 38.91% in 2018. There was an increase in primary section and repeat sections. Primary caesarean section rate was 57.67% compared to repeat caesarean section rate which was 42.33%. This increase in caesarean section rate is due to increase in indications like cephalo pelvic disproportion and pregnancy being associated with medical disorders (PIH, GDM, hypothyroidism). CONCLUSION Rising risk of caesarean section over one decade is attributed to increased antenatal surveillance, identification of High Risk pregnancies and frequent resort to elective sections in high risk situations.