IntrOductIOnEctopic Pregnancy (EP) is a pregnancy implanted outside the cavity of the uterus. It is well recognised as a life-threatening emergency in early pregnancy. The incidence of EP is around 1-2% in most hospital based studies [1][2][3][4][5][6].Diagnosis requires a high index of suspicion as the classic triad of amenorrhoea, abdominal pain and vaginal bleeding is not seen in majority of cases. Women may present with non-specific symptoms, unaware of an ongoing pregnancy or even present with haemodynamic shock. The contribution of EP to the maternal mortality rates in developing countries including India is not precisely known, with data from few studies indicating 3.5-7.1% maternal deaths due to EP [7,8].The purpose of this study was to appraise all the cases of EP managed at a tertiary care centre over a period of 6 years and, to determine the incidence, risk factors, clinical presentation, management and morbidity associated with EP. MAterIAls And MethOdsThis retrospective study was conducted at Pondicherry Institute of Medical Sciences, a 650 bedded, tertiary care teaching hospital in south India. The study was approved by the Institute Ethics Committee. The case records of patients diagnosed with EP between October 2009 and September 2015 were retrieved from the medical records department. Patient character istics like age, parity and risk factors for EP were noted. Mode of diagnosis, management modality, complications and need for blood transfusion were also recorded. The primary outcome measures studied were incidence of EP, their risk factors, mortality and morbidity in these women.Data was entered in MS excel spreadsheet and analysed using SPSS software version 19.0. For categorical variables, data was compiled as frequency and percent. For continuous variables, data was calculated as Mean ± SD. resultsOver the six-year period, 7832 pregnancies were diagnosed, among whom 72 pregnancies were extra-uterine. The incidence of EP was 9.1/1000 pregnancies or one in 108 pregnancies. Majority of the women were aged 21-30 years [Table/ Fig-1]. The most common risk factors were previous abortion (36.1%) and pelvic surgery (37.5%). Among the women who underwent pelvic surgery, 15 women had undergone tubectomy and two women had a tubal recanalization.The classic triad of amenorrhoea, vaginal bleeding and lower abdominal pain was present in 29(40.3%) cases. Acute abdominal pain was the most common complaint, seen in 59 (81.9%) women;

Background: The caesarean section (CS) delivery rate is steadily increasing worldwide, including India. Identifying the proportion of women in various categories as per Robson's ten group classification system and CS rate among them is important to bring down the increasing CS rate. Methods: This retrospective study was conducted at Pondicherry Institute of Medical Sciences (PIMS), a tertiary care teaching hospital in Puducherry, South India. The data was collected for the women delivered by CS during January 2011 to December 2011 and proportions in various groups as per Robson's ten-group classification system were calculated. Results: Among a total of 1123 women delivered during study period, 367 (32.6%) delivered by CS. The CS rates among various groups varied from 100% among women with breach presentation (group 6 and group 7) and abnormal lies (group 9) to 5.9% among multiparous women with spontaneous labour having single cephalic pregnancy (group 3). Among women with precious section, CS rate was very high (89.6%). Women with previous CS (group 5) contributed maximum (40.1%) to the total number of CS. Conclusions: In the present study, all women with breech presentation and abnormal lies delivered by CS and repeat CS was the highest contributor to all CS deliveries.

SummaryForty women presenting for elective Caesarean section under spinal anaesthesia were randomly assigned to have anaesthesia induced in either the sitting or right lateralpositions; 2.5ml0.5% hyperbaric bupivacaine was injected over 10s before the mother was placed in a supine position with a 20" lateral tilt. The onset time and height of the subsequent analgesic and anaesthetic block was measured. It took longer to site spinal needles in the lateral position (240 us 115s, p < 0.001). There was a faster onset of sensory block to the sixth thoracic dermatomal level (8 us IOmin, p < O.OOl), in the lateral group, although onset time to T, was comparable. There was no difference in maximum block height or degree of motor block. Mothers in the lateral group required more ephedrine in the first 10m after siting the spinal (13.5 us 10.5mg, p < 0.05).

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