Background: Increased incidence of ectopic pregnancy and its impact on women’s fertility in recent years need significant attention.Methods: A two years prospective study from January 2018 to December 2019 conducted to determine incidence, association of risk factors with ectopic pregnancy and find the most common risk factor of ectopic pregnancy in department of obstetrics and Gynaecology, a tertiary care Hospital in Pune.Results: During the study period 100 patients were diagnosed to have ectopic pregnancy. Incidence was 5.29 per 1000 births. Majority were in the age group of 20-24 years (42%), multiparous (59%) and belong to low socioeconomic state (62%). In majority of the patients (22%) no risk factors was found. Among the patients who had risk factors, the main risk factors for ectopic pregnancy were history of history of pelvic inflammatory disease (20%), previous tubal/abdominal surgery (12%), history of Infertility (10%), previous termination of pregnancy (10%), contraception with mirena IUS or IUCD in situ (8%) and a history of prior ectopic pregnancy (4%).Conclusions: In majority (78%) of patients risk factors for ectopic pregnancy was present and pelvic inflammatory disease was found to be a major risk factor for ectopic pregnancy.

Background: Systematic review to determine the epidemiological aspects and causes of maternal mortality there by exploring possibility of intervention and implementing Evidence-based health policies and programmes to prevent future maternal death. Aims and objectives of the study were to calculate the maternal mortality rate in our hospital, to assess the epidemiological aspects of maternal mortality, to assess the type of delay and causes of maternal mortality and to suggest ways to reduce the MMR.Methods: This is a 3-year retrospective study from January 2017 to December 2019 that will be conducted in the department of obstetrics and gynaecology, The Apollo medical college and District hospital, Chittoor a tertiary care teaching hospital situated in the southernmost part of Andhra Pradesh state in India. It gets a large number of referrals from PHCs, CHCs, and maternity homes as well as from hospitals across Chittoor district. Epidemiological data will be collected from the hospital register. Maternal mortality ratio, epidemiological factors and causes affecting maternal mortality are assessed.Results: MMR in present study was 66 per 1,00,000 live births. Women in the age group of 20 to 30 years (85.72%), illiteracy (57.16%) and low socioeconomic status (100%) were risk factors for maternal mortality. Obstetric haemorrhage (57.16%) is most common cause whereas type 1 and type 2 delays are most common contributing factors for maternal mortality.Conclusions: Early identification and management of pregnancy complication, strengthening of existing Emergency obstetric care (EmOC) facilities, easy transport and appropriate referral linkages are keys to reduce maternal mortality to further extent.

Background: RPOC can occur due to spontaneous or induced abortion followed by incomplete or partial expulsion of product of conception. Suction evacuation is currently the standard surgical treatment, but operative hysteroscopy has the advantage over Suction evacuation allowing the direct visualization of the retained conception product, facilitating its elective removal while limiting surgical complications.Methods: Comparative retrospective study of 80 patients who presented with RPOC during the period of 6 months. Hysteroscopy was done in 40 patients and Suction evacuation in remaining 40 patients. Data regarding anaesthesia required, mean time taken for procedure and post procedure hospital stay, complication due to the procedure and post-operative outcome were collected to compared,Results: In hysteroscopy group none of patients required anaesthesia and even though mean time taken for the procedure is 2 minutes more in hysteroscopy group without statistical significant difference (P 0.672), the post procedure hospital stay is less compared to suction evacuation group. Complication due to procedure was seen in 5 (12.5%) patients in hysteroscopy group which is less compared to 13 (32.5%) patients in suction evacuation group. Mean number of days of pain requiring analgesia and Sick leave applied was also less in hysteroscopy group (1 day and 2 days respectively) group compared to suction evacuation group (9 days and 7 days respectively)Conclusions: Lesser rates of intra and post-operative complications with hysteroscopy makes the procedure ‘safe’ to the patients and ‘effective’ as it ensures complete evacuation of the uterine cavity under direct vision and reduce the need for repeat procedure.

Background: Assessment of primitive reflexes is one of the earliest, easiest and most frequently used method among health care workers for newborns and young infants. Babinski reflex is one of the infantile reflexes. Our aim was to study Babinski reflex in a term neonates with hypoxic ischemic encephalopathy (HIE).Methods: This study is a cross-sectional observational study. 100 consecutive neonates fulfilling criteria of HIE according to Sarnat and Sarnat classification, admitted in our neonatal intensive care unit (NICU) were included. It was elicited from 12 hours after birth to 72 hours of birth. Babinski response was assessed using thumb nail drag method.Results: 78% babies are term babies. 22% babies are post term babies. Male to female ratio is 1.5:1. 38% neonates belong to HIE stage I, 39% and 33% neonates belong to HIE stage II and III respectively. In HIE stage I, planter grasp was elicitable in 89%. It remain non-elicitable in 44% and 91% in HIE stages II and III respectively.Conclusions: Absence of Babinski reflex can be correlated with the increase in severity of HIE. It is important to include the assessment of Babinski reflex along with other primitive reflexes in the newborn generally and especially in HIE.

Background:To compare the maternal outcome in patients treated with methyldopa and labetalol in the management of moderate to severe hypertensive disorders of pregnancy (HDP). Methods: The present study is Prospective parallel group comparative study on 200 out-patients and inpatients selected between January 2013 to December 2013 from OPD and antenatal ward of Obstetrics and Gynaecology department, of tertiary care teaching hospital, Regional Institute of Medical Sciences, Imphal. 100 patients each were distributed to methyldopa group and labetalol group respectively. Results: There was statistically significant reduction in the mean systolic BP + Standard deviation / Diastolic BP + Standard deviation and Mean arterial pressure (MAP) in Labetalol group (from 156.84 + 5.75/100.20 + 6.02 mmHg and 119.08 + 4.07 to 133.76 + 3.50/85.14 + 3.98 mmHg and 101.35 + 2.94) compared to Methyldopa group (from 156.00 + 6.581/100.96 + 6.896mmHg and 119.30 + 4.86 to 137.20 + 2.36/89.02 + 2.38mmHg and 105.08 + 1.78). Risk of adverse effects was less in Labetalol group (12%) but complication during pregnancy was more in Methyldopa group (51%). Number of spontaneous onset of labour and vaginal mode of delivery was more in Labetalol group.Conclusions: The present study shows that primiparity, residing in rural area, with low income group and overweight are at high risk of developing Hypertensive Disorders of Pregnancy. Labetalol is the better drug in controlling blood pressure with less adverse effects and maternal complication.