Ovarian pregnancy is a very rare form of ectopic pregnancy. (1) It was first described in 17 th century by Dr. Saint Monnissey. Incidence has been estimated around 0.5-3% of all ectopic pregnancies. (2) Incidence has increased in recent years due to increase in diagnosis which can be attributed to availability of USG facility, more sensitive β-hCG assay, diagnostic laparoscopy and risk factors associated with overall ectopic pregnancies. Use of IUCD has been disproportionately associated with primary ovarian pregnancy with incidence range being 57-90%. (3-7) Diagnosis is done by both surgical and histopathological observations. (8) Usually, it ends in rupture in early stage. (9) Classical management is surgicalwedge resection or oophorectomy. Medical management has been reported to be successful in few cases.

Objectives: The aim of the study was to evaluate the stiffness of cervix and determine its significance in predicting successful outcome of induction of labour. The primary objective was to determine the differences in elastography indices of different areas of cervix between the outcome groups of successful and failed induction of labour. A secondary objective was to find out the correlation of these elastography indices with Bishop’s score and cervical length. Methods: This was a prospective, observational study conducted over a period of 6 months on pregnant women admitted in the labour room for induction of labour. Establishment of adequate regular uterine contractions – at least three contractions lasting 40–45 s in a 10-min period – was taken as end point for successful outcome of induction of labour. Even after 24 h of initiation of induction of labour, regular, adequate and painful uterine contractions were not established, then induction of labour was described as having failed. Prior to induction, cervical length measurement, Bishop’s scoring and elastographic evaluation of the cervix were done by stress–strain elastography. A colour map was produced from purple to red and a five-step scale – the elastography index – was used to describe the various parts of the cervix. The differences between elastography indices of different parts of cervix were estimated using Mann–Whitney U test. Correlation of the indices with cervical length and Bishop’s score was determined by Spearman’s correlation coefficient. Results: A total of 64 women were included in the study. A significant difference ( p < 0.001) was found in the elastography index of internal os between the two outcome groups of success (1.76 ± 0.64) and failure (0.54 ± 0.18). However, the elastography index of central cervical canal, external os, anterior lip and posterior lips did not differ significantly across the outcome groups. A significant positive correlation was found between elastography index of internal os and cervical length (Spearman’s correlation coefficient, r = 0.441, p < 0.001) and between elastography index of external os and cervical length ( r = 0.347, p = 0.005), whereas a negative correlation was seen between elastography index of external os and Bishop’s score ( r = −0.270, p = 0.031). Conclusion: Elastography index of internal os can be used to predict outcome of induction of labour. Cervical elastography is a promising new technique for cervical consistency assessment. Further larger studies are required to determine some cut-off point for elastography index of internal os in prediction of outcome of induction of labour and to strongly establish the usefulness of cervical elastography for pregnancy management, preventing preterm delivery and establishment of cut-off points to determine successful induction.

Aims and objectives: To identify various factors for meconium stained amniotic fluid (MSAF) and comparison of pregnancy outcome in meconium stained vs. clear amniotic fluid. Material and Methods: The study was conducted at the Department of Obstetrics and Gynaecology of a teaching tertiary care hospital. Out of 850 deliveries, 100 cases of MSAF were studied for 17 months. Detection of MSAF during delivery and follow-up of mother and baby during hospital stay was done. Results: Overall incidence of meconium staining of AF during labor was in the present study 11.6%. The incidence of meconium staining was much greater in postdated pregnancy and oxytocin-induced labor. Birth asphyxia was more common when the AF was meconium stained and severity was directly proportional to the degree of thickness of MSAF. Abnormal heart rate was much more frequent in the study group and when thick meconium was associated with bradycardia fetal outcome was worst. Conclusion: Prevention of fetal distress and maternal hypertension can reduce MSAF to ultimately minimize cesarean /instrumental delivery and adverse fetal outcome. This study confirmed that our clinical impression– “meconium staining of amniotic fluid adversely influence the fetal outcome”

Aims and objectives: Meconium stained amniotic fluid was considered a sign of fetal distress and associated with poor fetal outcome, but others considered physiological phenomena to be meconium passage through the fetus and create environmental threats to the fetus before birth. Such magnitude of different opinions was the object behind taking up this study and the aim was to find out the incidence and effect of meconium in terms of morbidity and mortality. Material and Methods: The present study was undertaken to evaluate the significance of MSAF and its fetal outcome in parturients admitted to a tertiary care hospital between June 2012 to June 2014. Detection of MSAF during delivery and follow-up of mother and baby during hospital stay was done. A total number of 100 cases were studied in each group as a prospective study. Results: The total numbers of deliveries during the study period were 850 of which 100 cases had meconium staining of AF (11.6%). Thin meconium staining was seen in 37 cases (4.35%) and Thick meconium was seen in 63 cases (7.41%). The major neonatal complication was birth asphyxia in MSG (19%) which was more in thick MSG (14%). Neonatal morbidity was more in the newborn with the thick meconium group (36.5%) compared to the thin meconium-stained group (29.7%). Early neonatal mortality was 100% associated with thick MSG. Early neonatal death was 2 in thick MSG and it was due to MAS. Stillbirth was 100% associated with thick MSG and it was 4. Whereas stillbirth in the control group was 1. Perinatal mortality was 6% in MSG that was associated with thick MSG. In the control group, it was 1%. Consistency of meconium has a direct bearing on the fetal outcome. In the thick meconium-stained group, Neonatal morbidity was (in our study group) 23 out of 63 cases. Stillbirth was 4; early neonatal death was 2 out of 63 cases. Whereas in thin MSG neonatal morbidity was 11 out of 37 cases. No stillbirth or neonatal death occurred in thin MSG. Conclusion: Immediate airway management, need for suction, and intubation should be guided by the state of the newborn rather than the presence of meconium. Timely diagnosis and management of amniotic fluid stained with meconium can enhance the fetal outcome. The authors of the current study conclude that MSAF adversely affects the fetal outcome mainly by thick meconium.