Background: Hysteroscopy being the gold standard for evaluation of uterine cavity can be utilized for varied gynaecological indications. Conventionally, hysteroscopy is performed under general anaesthesia but with technical advances over years, it is now possible to do the procedure in ambulatory office setting with same diagnostic accuracy. Aim of this study was to assess the role of hysteroscopy as a diagnostic tool in office setting, to evaluate various gynaecological conditions.Methods: Study performed retrospective analysis on 1920 patients who underwent office hysteroscopy between Jan 2011 to Apr 2015, at outpatient department of a tertiary care centre at Maharashtra, India. The procedure was done in office setting without any sedation or anaesthesia. Approach used was vaginoscopic free hand technique with minimal instrumentation and the findings were documented after evaluation of uterine cavity, ostea and endocervical canal.Results: Office hysteroscopy could be successfully performed in 1920 out of 1938 patients. Most common indications were primary infertility (38.0%), secondary infertility (11.2%), abnormal uterine bleeding (36.6%) and postmenopausal bleeding (8.3%). The procedure done in office setting was tolerated well. The procedure was also used for evaluation in patients with breast and endometrial carcinoma.Conclusions: Office hysteroscopy by vaginoscopic approach is a simple and convenient method for evaluation of uterine cavity and cervical canal. It has the potential to come out from formal operation theatre to more patient friendly outpatient department.

Aim Obstetric patients presenting to the intensive care units (ICU) with or without underlying medical or surgical comorbidities can be a challenge to both the treating obstetrician and the intensivist. They occasionally present with near-miss events which if left untreated, can result in death. Objectives To study the prevalence, indications of ICU admissions, near-miss events, and their effect on mortality in obstetric and puerperal patients . Material & methods We conducted a retrospective analysis of the health records of all the obstetric and puerperal patients (pregnant and until 6 weeks postpartum) admitted to our tertiary care hospital from January 2019 to December 2020. Patient demographic characteristics, obstetric, surgical, and medical conditions, acute physiology, and chronic health evaluation (APACHE) II scores, organ failures, treatment, ICU and hospital length of stay, and mortality outcomes were studied. Results A total of 22 obstetric patients were admitted to the ICU during the above study period. Mean age was 28.7 ± 6.24 years, mean gestation was 34.4 ± 6.61 weeks, mean APACHE II score was 12.68 ± 5.67, median ICU length of stay was 5 days, and median duration of hospital length of stay was 10 days. The antepartum risk factors such as severe preeclampsia (27%), antepartum bleeding (14%), and postpartum complications like postpartum haemorrhage (33%), sepsis with multiorgan failure (25%) are the commonest indications that resulted in ICU admission. Conclusion Higher APACHE II scores at the time of ICU admission, prolonged ICU, and hospital length of stay may be associated with high maternal mortality.

Favorable pregnancy outcomes can be achieved after multifetal reductions during first trimester in higher-order multiples, but the procedure is not totally safe.

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