Background: The objective of this study was to evaluate the efficacy of spot urinary albumin creatinine ratio (UACR) as a predictor of preeclampsia and dilemma faced by clinicians in interpretation of lab values expressed in different units, lack of standardization and its further ramifications in long term follow up and prevention of complications of preeclampsia. Wide variation for estimation of UACR leads to confusion in practice guidelines and its interpretation as single International practical information regarding laboratory measurements, calculation, reporting and interpretation doesn’t exist. This prospective randomized study was conducted in Out Patient Department of Obstetrics and Gynaecology in a tertiary care hospital over a period of 1 year after due clearance was obtained from Ethical Committee.Methods: This was prospective study involving 400 ladies reporting for Outpatient ANC services within the given time period as per existing guidelines at a tertiary care hospital. Patients were assessed at first booking visit at 18-20 weeks, and thereafter based on clinical and haematological findings, severity of disease more frequently if desired and were admitted in case of imminent eclampsia. The mean age of the patients was 20.5±0.5 and 24.5±0.5 years and treatment duration were till successful delivery and 06 weeks postpartum for persistent microalbuminuria and exclusion of underlying medical cause for Hypertension. Fetomaternal morbidity and mortality was not a criterion of exclusion.Results: Compared with 24-hour urinary protein excretion, the spot UACR may be a simple, convenient, and accurate indicator of significant proteinuria and future complications in women with preeclampsia with proper and intensive clinical follow up and intervention to prevent feto maternal morbidity and mortality. A strong correlation was evident between spot UACR with high sensitivity and specificity.Conclusions: UACR measurement is a simple, quick, and reasonably reliable method for prediction and assessment of severity of preeclampsia. Spot UACR correlates better than spot UPCR to 24-hour urinary protein excretion to the severity of disease and as predictor of severity of disease.

Background: Dysfunctional Uterine Bleeding (DUB), is the commonest cause of Abnormal Uterine Bleeding (AUB). It causes morbidity, anaemia, and unnecessary hysterectomies in women of fertile age group. This study attempts to study efficacy of medical management especially Selective Estrogen Receptor Modulator (SERM) namely Ormeloxefine (ORM) (Sevista®) in Perimenopausal women. Ormeloxifene was marketed in India for contraception under brand names Centron, Saheli, Choice-7, Novex and Novex-DS. It’s a benzopyran derivative also known as Centchroman which causes asynchronousity between ovulation and menstrual cycles possibly because of both estrogenic and anti-estrogenic actions. It has been known to cause delay in ovulation in clinical trials; however, majority have been unaffected. It causes delay in proliferation of endometrium thereby causing asynchronous cycles. It also improves motility of ciliary lining of Fallopian tubes thereby reducing the chances of implantation of fertilized egg.  Methods: This study is aimed at evaluation of subjective and objective stastical benefits and side effects in treatment of DUB in perimenopausal age group with ORM and commonly used 19 nortestosterone compound (progesterone); Norethisterone (NET).Results: Primary outcome were analyzed at the end of every 3 months and at the end of one year finally. Secondary outcomes of the study in each arm were also assessed. There was stastically significant increase in Hb and stastically significant decrease in ET. Data analysis was done for variables in each arm by t-test to estimate the mean, median, range P and t value for a conclusion. Differences were taken as significant when P<0.05.Conclusions: ORM is a safe, cost effective, non-steroidal, non-hormonal drug with convenient dosage and better compliance for medical management of perimenopausal DUB with minimum focal pathology. Side effects observed need more evaluation with larger sample size to be statistically significant.

A case of intrauterine fetal demise with cord prolapse, presenting to the labour room in active labour. Labour was uneventful; however, it reminds of importance of institutional deliveries, alert midwives, and importance of dedicated obstetric operation theatres and teams to prevent adverse maternal and neonatal outcome.

An interesting case of Pelvic Tubercular Peritonitis, post MTP and IUCD insertion presenting as Severe Sepsis. Managed aggressively with Fluid, supportive measures and complete course of ATT. Case is being reported as an unusual complication post MTP and incidental reports in literature of spread of Pelvic Peritonitis in preexisting Genital Tuberculosis by haematogenous spread.

An interesting case of interstitial ectopic pregnancy in a primigravida managed by surgically assisted medical management with intracardiac instillation of KCl and methotrexate. It was diagnosed based on transvaginal and transabdominal ultrasound and procedure was done as USG guided under local anaesthesia in OPD by transabdominal route and immediate disappearance of foetal cardiac activity was noted on Doppler. She was followed up with serial sβ-hCG and TVS. She had no post procedure complication and was discharged on day 2 of procedure.