INTRODUCTIONThird stage of labour begins after the delivery of the fetus till the expulsion of the placenta and membranes. 1 Though the third stage constitutes short span of time, it is the phase of maximum maternal mortality and morbidity.One of the major hazards being post partum haemorrhage. PPH complicates approximately 4% of vaginal deliveries and 6% of caesarean deliveries. WHO statistics suggest 30% of maternal deaths worldwide with an estimated 1.25 million cases and morbidity in 20 million women annually are due to PPH. 2,3Uterine atony is the most common cause constituting about 80-90% of cases.4 So, we have to aim at increasing the tone of the uterus by using uterotonic drugs to reduce PPH. Various uterotonic drugs is available like Oxytocin, Ergometrine, Prostaglandins.5 To prevent and treat PPH, literature strongly suggests the use of active management of 3rd stage 6 which includes use of Oxytocin at the time of delivery of anterior shoulder, controlled cord traction, ABSTRACT Background: Post partum haemorrhage is the most common cause of maternal morbidity and mortality. Misoprostol is a prostaglandin analogue, used for management of post partum haemorrhage. It can be used by various routes with minimal side effects. This study is done to compare the different routes of administration of Misoprostol for the third stage management and their side effects. Objectives of present study were to estimate the amount of blood loss, to assess the maternal side effects of drug, to know the haemoglobin deficit, to know the duration of third stage of labour. Methods: This was a prospective hospital base study of 150 women delivery at obstetrics and gynaecology department at ESICMC Model Hospital, Rajajinagar. They were randomized into 3 groups of 50 patients each. They received 400 µg of misoprostol either orally or rectally or sublingually immediately after delivery of the fetus. The primary outcomes analysed were amount of blood loss duration of third stage of labour haemoglobin deficit and their side effects Results: The amount of blood loss and haemoglobin deficit was least in sublingual group which was statistically significant. Need of additional oxytocics was less in sublingual and oral group, though it was not statistically significant. Conclusions: In the present study, sublingual Misoprostol was found to be more effective in reducing blood loss during third stage of labour.

This is a cross sectional, single visit, outpatient clinic based study done on 100 female patient with history of at least one spontaneous pregnancy loss of less than or equal to 20 weeks gestation over a period of 6 months. In our study we aimed to evaluate the prevalence of recurrent spontaneous miscarriages and associated risk factors. The overall estimate of miscarriages in the present study was approximately 15% and the prevalence of recurrent spontaneous miscarriages was 3%. Spontaneous abortion/ miscarriage is heterogeneous condition and remarkably difficult to measure as many happen very early in the pregnancy.

Objectives: The present study was designed to study the risk factors of ectopic pregnancy and their clinical presentation. Material and methods: It was a retrospective study with 100 cases of ectopic pregnancy conducted in the Department of Obstetrics and Gynecology, ESIC MC PGIMSR, Rajajinagar, Banglore for a period of 2 years were included. Detailed history suggestive of risk factors for ectopic pregnancy, menstrual and obstetric history was taken. Results: A total of 7200 pregnancies were confirmed during the study period, of which 100 cases of ectopic pregnancies were diagnosed, giving an incidence of 1.38%. Sixty three percent were in the age group of 21-30 years. Seventy six percent of women were multigravidae. Forty eight percent of the patients had identifiable risk factors, of which past history of pelvic inflammatory disease in 28%, history of previous abortion in 16%, infertility in 10%, history of previous ectopic pregnancy in 14%, history of previous caesarian section in 18% and tubectomy in 14% were noted. Ninety six percent had amenorrhea, followed by pain abdomen in 88%, bleeding per vagina in 78%, fainting and syncopal attack in 16% of the patients. Pallor in 56% of the cases, 10% presented with shock. Conclusion: The early diagnosis of an ectopic pregnancy is one of the greatest challenges for a physician. It requires a high index of suspicion in case of clinical presentation of pain abdomen, bleeding per vagina with amenorrhoea. The importance of an early diagnosis lies in the fact that the patient can be offered a conservative line of management which can definitely have a beneficial effect on her future fertility.

Ectopic pregnancies can have varied presentations. They are common in reproductive aged women. Here, we report series of case reports of ruptured ectopic pregnancies whose clinical signs & symptoms included history of amenorrhea, irregular bleeding with no pain and no cervical motion tenderness on internal examination. The increased ratio of extra uterine to intrauterine pregnancy is related to the rising incidence of STD.