Objective: The present study was done to know and compare the incidence of congenital malformations in singleton and multiple births in our hospital & compare with other studies. Methods: A retrospective study done by collecting the data from parturition register from Jan 2008 to Dec 2011 (4yrs) from Cheluvamba Hospital attached to Mysore Medical College and Research Institute. Total number of the live births, still births, and abortions> 20 wks were collected. Details of multiple births such as maternal age, gestational age, sex & birth weight of the babies, U/S reports and congenital anomalies (CA) were noted. Results: The total number of singleton births were 48700 and number of babies who had congenital malformations were 235 (48.25/10,000 births).Total number of multiple births were 579 including 10 triplets and number of babies who had CA were 11 (189.98/10,000 births, P<0.0001). In the present study sex of the babies were noted in all multiple births and zygosity could not be recorded. Among 579 multiple births 404 were of the Same Sex (SS) and 165 were of Opposite Sex (OS) in twins and 6 were of the same sex and 4 were of opposite sex in triplets. According to Weinberg formula 50% of same sex (SS) twins are monozygotic and 50% are dizygotic twins. Among the 11 babies with CA, 4 monozygotic twins had anomalies related to twinning such as Acardia with TRAP sequence (3 twins), and Thoracophagus (1 twin).5 babies had CNS anomalies, 1 with cystic hygroma, 1 baby with multiple system affected. Conclusion: The incidence of birth defects is more in multiple births and especially in monozygotic twins. In the present days increase in twinning rate due to advanced maternal age, hereditary factors and use of ovulation inducing drugs, which results in premature and low birth wt babies associated with poor lung maturity. [Int J Res Med Sci 2013; 1(3.000): 216-221

Background: Oligohydramnios is one of the major causes of maternal and perinatal morbidity and mortality. It is a clinical condition characterized by Amniotic Fluid Index (AFI) ≤5 cm by sonographic assessment. The aim of present study is to know the maternal and fetal outcome in oligohydramnios after 34 weeks of gestation compared with women who had normal volume of amniotic fluid.Methods: Study was done for the period of 21 months from November 2014-July 2016 at Adichunchanagiri Institute of Medical Sciences, Hospital and Research Centre Bellur. 50 antenatal cases with > 34 weeks of gestation with AFI ≤5 cm by ultrasonographic estimation were included as study group and 50 women with normal AFI were included as control group. Maternal and fetal outcome of the women with oligohydramnios were analyzed and compared with control group.Results: Results were analyzed statistically using parameters like mean, SD, Chi Sq test, P value. Amniotic fluid was clear in 32% in study and 78% in control group, thin meconium stained in 30% in study group and 14%in control group and was thick meconium stained in 38% in study group and 8% in control group (Chi square =22.31, p<0.0001). Induction of labour was done in 54% in study group and 20% in control group. Cesarean delivery was done in 58% in study group women and 28% in control group women. Regarding the birth weight of babies 62% were < 2.5 kg in study group and 18% in control group with p<0.001. 10% of babies in study group required NICU admission and perinatal mortality was 2%.Conclusions: Due to increased perinatal morbidity and mortality and increased rate of LSCS, timely decision during labour is important to reduce perinatal morbidity and mortality.

Background: Labour although a physiological process can present challenges to clinician and patient. Primigravida and nulliparae are obstetric high-risk group, especially the very young and the elderly, where pregnancy and labour must be supervised. The study was done to compare the maternal and fetal outcome in primigravida with unengaged and engaged head at term.Methods: A prospective study was done for a period of 18 months from June 2018 to December 2019 in Department of Obstetrics and Gynaecology Adichunchanagiri Institute of Medical Sciences and Research Center. 100 women with unengaged head at term (group A) and 100 women with engaged head at term (group B) as controls were selected.  All the relevant data was filled in the partogram. Following observations were made, station of fetal head at the onset of labour, course of labour, duration of labour, any medical or surgical interventions or caesarean delivery. Data was analysed by SPSS 20.0 software and p value<0.05 was taken as statistically significant.Results: in group A 49% and 63% in group B had vaginal delivery. 17% of group A and 14% of group B had instrumental vaginal delivery. Caesarean delivery was 34% in group A and 23% in group B. The mean total duration of labour was 13.53 hours in group A and 9.73 hours in group B. P value was 0.000.Conclusions: Duration of labour was more in group A than group B.  Proper supervision and timely intervention in cases with an unengaged head can have vaginal delivery.

Objective: The aim of study is to know the maternal and fetal outcome in the present pregnancy of patients with previous one caesarian section (CS). Methodology: A prospective study was undertaken to know the neonatal and maternal outcome in patients admitted with previous cesarean section for the period of 1 yr and 9 months from October 1998 to June 2000. Vaginal delivery were monitored and failed trial cases were taken for repeat CS. Maternal and neonatal outcome was studied in the VBAC and repeat CS cases. Results: Among the total 14164 admissions to labour ward, there were 942 patients with previous CS (14.87%). Elective CS was done for 530 cases and 412 cases were planned for trial of labour and out of them 311 had vaginal deliveries, with success of vaginal birth after cesarean (VBAC) of 75.48%. There were 5 cases of rupture uterus and subtotal hysterectomy was done in 3 cases and closure of rent was done in 2 cases. Repeat CS was done in 96 cases. Neonatal outcome in VBAC babies was, 83.28% healthy, 7.72% had morbidity and admitted to neonatal intensive care unit (NICU) and 9% had mortality. Neonatal outcome in repeat CS were normal in 32.3%, morbidity and admission to NICU was 41.66% with a mortality of 26.04%. Maternal mortality occurred in 2 unbooked patients, 1 was associated with asthama and COPD, another with severe anemia with scar rupture. Conclusion: VBAC is more successful in cases with previous non recurrent indications. Vigilance regarding the indication of primary CS, proper patient selection and counseling for trial of scar, careful observation throughout in a well equipped unit are key to reducing CS rate.

Background: There is increase in number of primary cesarean sections, leading to more number of women facing the issue of mode of delivery in the current pregnancy. There are reports about success of vaginal birth after cesarean section as well as complications such as scar dehiscence, rupture of uterus, poor maternal and fetal outcome.Methods: A prospective study was done for a period of 1 yr and 9 months at Cheluvamba Hospital attached to Govt Medical College Mysore from October 99 to June 2000. Data regarding previous cesarean section was collected, clinical findings during the present pregnancy were noted.Results: During the study period there were 942 women admitted with previous history of cesarean section. Elective repeat cesarean section was done for 530 cases and trial of labour after cesarean section was planned for 412 cases. Successful vaginal delivery was conducted in 311 cases. Repeat emergency cesarean section was done for 96 cases due to failed trial of labour. Maternal morbidity such as adhesions was seen in 11.25% and obliteration of U V fold in 7.92% of cases. Maternal mortality was seen in 0.15%. Perinatal morbidity was seen in 3.32%, perinatal mortality in 3.96%.Conclusions: With increasing proportion of women with previous cesarean sections, it is essential to counsel these women during trial of vaginal delivery in well equipped hospitals. It is worth to reduce primary cesarean section to avoid complications in consequent pregnancies. Proper and timely decision for repeat cesarean sections will reduce fetal and maternal morbidity and mortality.