Eighty-eight cases of abdominal wall defect with and without other lesions were ascertained by reviewing all labour room records in the West of Scotland, all surgical admissions to the Royal Hospital for Sick Children, Yorkhill, and all post mortems at Royal Hospital for Sick Children between 1978 and 1981. The affected cases comprised 39 terminations of pregnancy (17 of anterior abdominal wall defect without neural tube defect), 20 spontaneous stillbirths and 29 livebirths. All 10 cases of body stalk anomaly, 37.5 per cent of 16 gastroschisis cases and 53 per cent of 62 exomphalos cases had additional severe abnormalities. Abnormal karyotypes were present in seven out of 19 exomphalos cases but all karyotypes from 10 gastroschisis and 6 body stalk anomaly cases were normal. No correlation was found between the maternal serum AFP levels, the amniotic AFP levels and acetylcholinesterase results and the size of the lesion. It is proposed that anterior abdominal wall defects detected prenatally should have chromosome analysis and careful ultrasound to exclude associated severe anomalies before coming to a decision about termination. This policy was implemented in six pregnancies complicated by fetal gastroschisis without severe associated anomalies which were identified in the second trimester and continued to term. Immediate surgical repair was achieved in each case, although two of the infants succumbed from later complications of gastroschisis closure and one from respiratory distress syndrome. The remaining three infants made a satisfactory recovery.

No abstract

INTRODUCTIONAn intricate inspection and examination of one's body is a source of anxiety mixed with hesitance for every woman. A glimpse into history demonstrates that until recently examination of women was handled by females likely to ensure comfort and privacy. In compliance with religious doctrine, men were not allowed to be present at rituals related to birth and other gynecological examinations. In India, traditionally women and their relatives also prefer female relatives to accompany them when they attend obstetric and gynecology (OBGY) outpatient department (OPD) of public hospitals unlike in Western countries. A husband at antenatal and gynaecology clinic is quite uncommon in many communities and it is unthinkable to find men accompanying their partner or other female relative during antenatal care or gynaecological examinations. 1 ABSTRACT Background: Involvement of male relative in management of female reproductive disorders is low in many countries including India. Active participation of male relatives by establishing male friendly approach in Obstetrics and Gynecology (OBGY) outpatient department is a novel concept. This study explores the perceptions of male relatives accompanying the patients regarding male friendly approach which constitutes attitude of medical and paramedical staff towards them, involvement of male relatives in counseling and their role in decision making in obstetrics and gynecology outpatient department. Methods: This prospective study was carried out over three months in Obstetrics-Gynecology outpatient department of a tertiary care teaching hospital. Male relatives accompanying the patient were enrolled in the study. The participants were allowed to remain present at the time of history taking and post examination counseling. They were also asked to be part of the decision making whenever required. Feedback from the male relatives was obtained using a questionnaire. Results: Out of 450 patients attending the OBGY Outpatient Department (OPD) during the three months study period 100 were accompanied by male relatives. Participation in decision making was the commonest reason for accompanying the patient (36%). All the male relatives involved in this study were satisfied with the approach of doctor and paramedical staff and 85% were willing to accompany their female relative at every visit. Conclusions: Making health services for women more male friendly would increase participation of male relative in healthcare of female reproductive disorders. This can improve women's health and eventually reduce maternal and neonatal morbidity and mortality.

Background: Cesarean scar pregnancy is one of the rarest forms of ectopic pregnancy in which implantation occurs in the scar of a previous cesarean section. Due to increased incidence of cesarean section and first-trimester scan worldwide, more and more cases are diagnosed and reported nowadays.Case report: A 25 years G3P2A0L2 patient with previous two LSCS was referred and admitted in an emergency with chief complaints of one and half months amenorrhea followed by bleeding per vaginum for 2 days preceded by intake of MTP pills 8 days back. Her general condition was fair. The patient was investigated with routine investigations, transvaginal ultrasound, Doppler and beta hCG. Ultrasonography (USG) and color Doppler findings were suggestive of cesarean scar pregnancy. Conservative management with methotrexate was done with strict follow-up. The GSAC completely resolved by 72nd and day of diagnosis. Second look scopy at the time of tubal ligation reaffirmed the diagnosis and resolution of the scar pregnancy.