Background: Worldwide CSR has been steadily increasing beyond recommended level of 15 %by WHO. High CSR have been reported in developed and developing countries. Reasons for increase in CSR are not obvious and somewhat complex. Thus, present study was undertaken to analyze various indications for CS performed at rural tertiary health care centre Sewagram, M.S.Methods: This was prospective study included all women who underwent CS from 1st January 2015 till 30th June 2016. Data was entered in MS excel sheet analyzed with percentage and chi square test using SPSS ver.17.Results: CSR was 36 .88% in present study. As per NICE guidelines CS were classified in four categories based on urgency, women were distributed in each category. Category I had 22.62%, category II -38.61%, category III - 28.37% and Category IV - 10.40% women. In CAT I common indication was foetal bradycardia (71.53%). In CAT II CS, common indication was non reassuring foetal status (38.82%).  Breech presentation (14.74%) and previous scar with doubtfull scar integrity (14.33) were next common indications. In CAT III (43.43%), IV (41.13%) previous LSCS with inadequate pelvis was the common indication. Confidential enquiry revealed that 26.17% (28/107), 20.3% (40/197), 23.17%, (35/151) and 8.3 % (5/60) of CAT I, II, III and IV CS had questionable indications.Conclusions: In this study, CSR was higher than WHO standard. Common indications in primipara was foetal distress while in multiparas primary indication previous LSCS

Background: Uterine fibroids are commonest benign uterine tumors. Only about 25% women with fibroids are symptomatic. Around 70-80% are discovered incidentally during routine pelvic examination. Using ultrasonography screening, some authors have estimated a cumulative incidence of 70% in all women by age 50. Symptoms attributable to fibroids are mainly abnormal uterine bleeding (AUB), pelvic pressure, pain, and reproductive dysfunction. Heavy and/or prolonged menses is the typical bleeding pattern with myomas. Uterine fibroids are a leading cause of hysterectomy in perimenopausal women, thus, this study was done to find out its prevalence and demography in women presenting with AUB. The objectives of the present investigation were to find out the prevalence of uterine fibroid in women with AUB and to find out the various demographic features of womenMethods: The study was done for 2 years in the Dept of Obstetrics and Gynecology of a rural tertiary institute after taking clearance from institutional ethical committee. All the women presenting with AUB were included in the study. History and demographic features was enquired and entered in a predesigned proforma. All women were clinically examined after consent. Women with suspicion of fibroid were subjected to diagnostic modalities and the reports were followed and correlated.Results: Total 11,841 patients came to Gynaeological OPD during the study period. Out of these 3,878 (32.75%) presented with AUB, 2,126 were diagnosed as having fibroids after examination and investigations. Hence, the prevalence of fibroids amongst the women with AUB was 54.82% and 17.95% amongst all gynaecological patients. Maximum women were between 31-40 years, (64.78% rural and 62.73% urban). Majority were having parity between 1-2 (40.73% in urban, 38.96% in rural).Conclusions: Uterine fibroids are the commonest reason of AUB in reproductive age group with the prevalence of 54.82%. The trends in age incidence have remained the same over the years, commonly affecting women in third decade. There is no difference in incidence of fibroids amongst various socioeconomic classes.

Context: Retrospective study was carried out to answer whether or not the partographs that are used to monitor mothers in labour are recorded to the standard. A fuller understanding of this process will be important to educate further the personnel filling the partograph and also to make policies and strategies in the provision of maternity care services. Objectives: 1) To determine whether the partographs are correctly being filled. 2) To find out which part of the partograph is not being properly filled. Methods: 100 case records of women delivered in Kasturba Hospital and monitored by partograph, were randomly selected from a period of January -May 2015 (20 records per month) and retrospectively studied by a team of 2 assessors. After defining inclusion and exclusion criteria, data was collected through a pre-tested and structured checklist which was developed, after reviewing literature relevant to the problem under study and standard protocols were defined to identify correctly filled partographs and substandard ones. Results: Overall 69 % of the partographs were correctly filled. Fetal heart rate was recorded up to the recommended standard in 78(78%) of the partographs reviewed. In 20 (20%) moulding of fetal head was not recorded at all. The status of membranes was recorded in 78 (78%). Cervical dilatation was recorded in 96 (96%) of the partographs however, 9(9%) of these records were substandard while it was not recorded in 4(4%). Uterine contraction was not recorded in 10 (10 %) while recorded to the standard in 71(71%). Descent of the presenting part was not recorded in 49(49%). 90 (90%) women had their blood pressure monitored. Post delivery baby notes were recorded in 96 (96%) of the partographs. Conclusion: The present study revealed significant proportions of substandard and unrecorded parameters of labour on the modified WHO partograph. This indicates poor documentation, and perhaps monitoring and supervision of labour. Lack and suboptimal documentation of some parameters of the progress of labour could hinder early detection of complications, important to prevent maternal and perinatal mortality and morbidity. Pre-service and periodic on-job training of health workers on the completion of the partograph, regular supportive supervision, provision of guidelines and mandatory health facility policy are recommended.