Most of the previous randomized controlled trials have shown no advantage of electronic fetal monitoring (EFM) over intermittent auscultation (IA) in either low-or high-risk pregnancies [1-3], but studies specifically regarding postcesarean pregnancies are sparse. The American College of Obstetricians and Gynecologists recommends both EFM and IA as equally effective in monitoring labor in women with postcesarean pregnancies, whereas British protocol recommends continuous electronic fetal monitoring [4]. In India, IA is the standard practice for monitoring labor in these women. The present study compares the effectiveness of EFM and IA in the intrapartum surveillance of women with postcesarean pregnancies.A total of 100 pregnant women with postcesarean pregnancies were divided randomly into 2 groups of 50 each, the IA group and the continuous EFM group. All women had a history of 1 lowtransverse cesarean section; had a singleton pregnancy; were in the active stage of labor with cephalic presentation; and had no obstetrical or medical contraindication for vaginal delivery. Electronic fetal monitoring was performed using a Huntleigh Duplex cardiotocographic device (Model BD 4000; Huntleigh Diagnostics Ltd, Cardiff, England). In the IA group, auscultation was done for 1 min after each contraction, and uterine contractions were evaluated by palpation. Fetal heart rate (FHR) was monitored every 15 min during the first stage and every 5 min during the second stage of labor in both groups. Nonreassuring FHR patterns in the EFM group were defined as the presence of persistent late or prolonged decelerations; severe variable decelerations; variable decelerations with a rising baseline and loss of variability; persistent 0020-7292/$ -see front matter D

A prospective observational study was conducted at Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, India on 300 pregnant women with one previous caesarean section fulfilling the eligibility criteria for trial of labour, to study the predictive factors and the outcome of trial of labour. The data obtained were analysed according to mode and outcome of labour and was then subjected to statistical analysis. The success rate of trial of labour was found to be 53.6%. Favourable Bishop's score (p = 0.000), spontaneous onset of labour (p = 0.005) and history of previous delivery after caesarean (p = 0.007) were significantly associated with a successful outcome of trial of labour. Higher chances of vaginal delivery were found with breech as an indication of previous caesarean section, i.e. 67.1% as compared to 39% with non-progress of labour as an indication.

Osseous metaplasia is a rare disorder of the endometrium that usually leads to secondary infertility and is frequently associated with recurrent abortions. Here we present two cases: one presenting with primary infertility and another presenting with oligomenorrhea. In both cases, vaginal ultrasonography showed an intrauterine structure that appeared hyperechogenic, suggesting calcification. Hysteroscopy revealed multiple white spicules of bony material in the uterine cavity. In both cases, the lesion was treated by hysteroscopic removal without complications. Histology established a diagnosis of endometrial osseous metaplasia. Thus, hysteroscopy was effective in the diagnosis and treatment of endometrial osseous metaplasia. The patient with primary infertility had spontaneous conception of twins 6 months after the procedure.

Introduction. Mature cystic teratoma is the benign tumor of the ovary. CA19-9 levels, although a marker of pancreatic malignancy, have been found to be raised in large ovarian mature cystic teratomas. Case Report. We report a case of a young female who had unusually high levels of CA19-9 in the blood associated with large ovarian mature cystic teratoma. The levels returned to normal 12 weeks after cystectomy was performed. Conclusion. This case highlights the fact that although raised tumor marker may be associated with a benign pathology thorough evaluation to rule out malignancy still must be done.

Objective: To compare the efficacy and safety profile of low dose vaginal misoprostol with dinoprostone gel for induction of labor in term pregnancies. Methods:The study was conducted at Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital on 100 pregnant women with term pregnancy after application of inclusion and exclusion criteria. The women were randomized in 2 groups of 50 women each. Group I received misoprostol 25µg at every six hour vaginally for a maximum of five doses for induction of labor; while group II received dinoprostone gel 0.5 mg every six hourly for a maximum of three doses. Maternal outcomes such as mode of delivery and induction delivery interval; and fetal outcomes such as APGAR score and incidence of NICU admission were assessed in both the groups. Statistical analysis was done using student t-test and chi-square test.