Growth hormone (GH) is involved in the regulation of male and female infertility and has been used in the management of both male and female infertility. GH is also produced by the ovary apart from it being produced from pituitary. GH helps in monofollicular growth. GH therapy is one of the adjuvant treatment used in ovarian stimulation and Assisted Reproductive Technologies Assisted Reproductive Technology (ART). GH supplementation has been shown to improve pregnancy rates in poor responders. Growth hormone cotherapy has a definite role to play in ovarian stimulation and is effective in appropriately selected cases. However, it cannot be recommended indiscriminately in every patient undergoing ovarian stimulation or assisted reproductive technology.

Objective : To compare the outcome of restricted versus routine use of episiotomy in a tertiary care center. Method : A prospective observational study was conducted for singleton normal vaginal term deliveries. Deliveries managed with routine use of episiotomy formed the 'Control Group', while those managed with restricted use of episiotomy formed the 'Study Group'. Data so obtained was analyzed. Results : Total number of deliveries analyzed was 458 ('Control Group': n=210, 'Study Group': n=248). Restricted use of episiotomy led to 64% (n=159) women delivering without any perineal laceration, in 'Study Group'. This translated into 41% (n=38) reduction in the number of perineal lacerations in primipara, and 23% (n=36) in multipara, compared to the 'Control Group'. Only 2% of primipara in 'Study Group' had severe third degree perineal tears. Conclusion : Restricted use of episiotomy resulted in considerable reduction in maternal morbidity due to perineal lacerations.

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Post-partum hemorrhage (PPH) is a life-threatening obstetric complication and the leading cause of maternal death. The usual manner for its management includes, first, noninvasive and nonsurgical methods, and, then invasive and surgical methods. However, mortality and morbidity related to PPH still remains unacceptably high, contributing to hysterectomy in at least 50% of cases. Early, effective, and preferably noninvasive treatments that can reduce maternal mortality and morbidity due to this entity are therefore essential. One of the most spectacular advancements in the control of PPH has been the use of recombinant activated factor (rFVIIa), both as initial and a life- and uterus-saving therapy. rFVIIa also reduces costs of therapy and use of blood components in massive PPH. In cases of intractable bleeding with no other obvious indications for hysterectomy, administration of rFVIIa should be considered before surgery. A MEDLINE search was done to review relevant articles in English literature on use of rFVIIa in PPH. Data were constructed and issues were reviewed from there. Our experience in a series of three cases of PPH, two of atonic and one of traumatic, successfully managed using rFVIIa is also shared.