Background: Ectopic pregnancy is a global problem and is the most common life-threatening emergency in early pregnancy leading to significant morbidity and fetal loss. It occurs in variable presentations. The rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. The aim of this study was to determine the incidence, clinical presentation, risk factors, treatment, and morbidity and mortality associated with ectopic pregnancy.Methods: The present retrospective study was conducted over a period of three years in the department of obstetrics and gynecology at SMS and R, Greater Noida, UP from Feb 2014 to Jan 2017.A total of 80 patients with ectopic pregnancy were analyzed regarding clinical presentation, risk factors, operative findings and treatment modality.Results: Total number of 80 cases of ectopic pregnancies were admitted during this period against 2645 deliveries representing frequency of 3%. Majority of cases (43.75%) were in the age group of 25-29 years and 41.25% were gravida 4 and above. Risk factors were identifiable in 66.25% of cases. Previous abortion was the most common risk factor (31.25%). The classical triad of amenorrhea, pain abdomen and vaginal bleeding was present in 71.25% of cases. More than half of case (55%) had ruptured tubal pregnancy on admission. Unruptured tubal pregnancy was seen in 10% case. Interestingly we found one rare case of bilateral ectopic pregnancy. Salpingectomy by open method was the mainstay of treatment (86.25%).Conclusions: Ectopic pregnancy is still a major challenge in gynecological practice. In our country most of the cases present late after tubal rupture requiring radical surgical treatment. Early diagnosis and timely intervention in the form of medical treatment or conservative surgery not only reduces maternal morbidity but also preserves future fertility.

Objectives:To evaluate the efficacy of shortduration, open-ended ureteral catheter drainage as a replacement to indwelling stent, and to study the effect of tamsulosin on stent-induced pain and storage symptoms following uncomplicated ureteroscopic removal of stones.Design: Prospective randomised study.Setting: School of Medical Sciences and Research, Sharda University, Greater Noida, India. Patients:Patients who underwent ureteroscopic removal of stones for lower ureteral stones between November 2011 and January 2014 were randomly assigned into three groups. Patients in group 1 (n=33) were stented with 5-French double J stent for 2 weeks. Patients in group 2 (n=35) were administered tablet tamsulosin 0.4 mg once daily for 2 weeks in addition to stenting, and those in group 3 (n=31) underwent 5-French open-ended ureteral catheter drainage for 48 hours. Main outcome measures:All patients were evaluated for flank pain using visual analogue scale scores at days 1, 2, 7, and 14, and for storage (irritative) bladder symptoms using International Prostate Symptom Score on days 7 and 14, and for quality-of-life score (using International Prostate Symptom Score) on day 14.Comparison of efficacy and tolerance of shortduration open-ended ureteral catheter drainage and tamsulosin administration to indwelling double J stents following ureteroscopic removal of stones New knowledge added by this study • This study shows that short-duration (up to 48 hours) ureteral drainage following ureteroscopic removal of stones (URS) has better efficacy and tolerance than indwelling stent placement with respect to the need for postoperative drainage. Hence, this can be a replacement for double J stenting.• Routine tamsulosin administration in patients with indwelling stents following URS has beneficial effects not only on irritative bladder symptoms but also on flank pain (both persistent and voiding). Implications for clinical practice or policy • Replacement of stents with short-duration open-ended ureteral catheter drainage provides early and more rehabilitation to the patients following URS. This is a viable option because there is no need for follow-up for stent-related symptoms, or maintaining records for planning its removal (no lost or retained stents).• It avoids a second invasive endoscopic procedure of stent removal, thereby reducing the medical and financial burden on the patient (especially important in developing countries). Patients are more likely to undergo URS again if required in the future (with stone recurrence) than opt for less effective or expensive choices like medical management, shock wave lithotripsy, or alternative forms of medicine.• In stented patients, tamsulosin administration improves the overall quality of life, and makes the period with stent in situ more bearable and asymptomatic.

Background: Management of critically ill patients in obstetrics is a challenge owing to the changed physiology and unpredictability of the disease behaviour. Stratification strategy for early admission to obstetric ICU is imperative to reduce maternal morbidity and mortality. Due to lack of formal surveys regarding obstetrical ICU in our country, there is lack of precise national data on obstetrical ICU mortality. Aim of the present study was to estimate the obstetric ICU admission rate, to study the pattern of causative aetiology and to study the complications developed in ICU.Methods: The present study is a retrospective analytical study done in the Department of Obstetrics and Gynecology, from January 2015 to August 2017.Results: During the study period there were a total of 8466 obstetrical admissions, 2508 deliveries and 104 ICU admissions. Out of 104, analysis was done on 71 patients. Hypertensive disorders of the pregnancy were associated with maximum number of admissions (47.8%), followed by postpartum haemorrhage (12.6%). Maximum admissions were in postpartum period (63.4%). Anaemia was associated with 35.2% of the cases and it was closely followed by sepsis (28.2%). Mechanical ventilation was required for 30.9% of the patients.Conclusions: Hypertensive disorders of the pregnancy, haemorrhage and sepsis are the major risk factors for ICU admission in obstetric population.

Most of the newly diagnosed cases of thrombocytopenia in pregnancy are mild, asymptomatic and accidentally discovered on routine antenatal screening. Common causes for the same include gestational thrombocytopenia, Preeclampsia, HELLP syndrome, and less commonly immune causes like ITP. As a matter of fact, HELLP and Preeclampsia have specific diagnostic signs and symptomatology, others are rather difficult to distinguish, as they are usually asymptomatic. We present a case of 21 years second gravida at 35 weeks and six days period of gestation, referred from a local practitioner for severe thrombocytopenia (Platelet count-20000/mm3). She had history of previous still birth due to cord prolapse, and severe thrombocytopenia (Platelet count-6000/mm3) in previous pregnancy. She recovered rapidly and spontaneously in postpartum period. The newborn platelet count was also normal. She was considered to be a case of rare but severe recurrent gestational thrombocytopenia, after ruling out other causes of severe thrombocytopenia in pregnancy. Management includes adequate preparations for ensuring optimal fetomaternal outcome. Treatment initiation and modification should be done, with preparation and anticipation for regional anesthesia, blood loss and appropriate styptic measures.

Pregnancy in a non-communicating rudimentary horn is of very rare occurrence. Delayed and initial misdiagnosis can result in catastrophic outcome both for the fetus as well as the mother. We present a case of 24 years old G 3 P 2 L 1 with ruptured pregnancy in a rudimentary horn which due to misdiagnosis resulted in maternal near miss.