Objective: The aim of the study was to assess the pregnancy outcome in pregnant women with oligohydramnios at term pregnancy. Materials and Methods: This is a prospective, case-control study which was conducted at Silchar Medical College and Hospital over a period of one year from July 2016 to June 2017. It included 140 pregnant women at term pregnancy with amniotic fluid index ≤ 5cm. The control group included 200 pregnant women at term pregnancy with amniotic fluid index > 5cm. The two groups were compared. Statistical analysis was done using the Fisher's exact test to calculate the P value. Results: There was a significantly higher incidence of low fetal biophysical profile, induction of labour, overall caesarean rates and caesarean due to nonreassuring fetal status, fetal distress, low birth weight babies, 5 minute Apgar score ≤ 6, neonatal intensive care unit (NICU) admission rates, hypothermia, meconium aspiration syndrome and perinatal death in the group with oligohydramnios as compared to the group with normal liquor volume. The incidence of instrumental delivery, fetal congenital anomaly, hypoglycaemia, hypoxic ischaemic encephalopathy, neonatal jaundice was higher in the oligohydramnios group but was not statistically significant. Conclusion: Oligohydramnios adversely affects the perinatal outcome. However, a favourable outcome can be expected by good antepartum and intrapartum surveillance and neonatal care.

No abstract

BACKGROUNDIntrauterine foetal death is an unfortunate event met in obstetric practice. Misoprostol has emerged as an efficient and relatively safe drug to deliver the baby in this condition. The objective of this study is to evaluate the safety and efficacy of vaginal misoprostol tablets for the induction of labour in intrauterine foetal death. MATERIALS AND METHODSThis uncontrolled clinical trial was performed on 100 women with intrauterine foetal death from January 2016 to December 2016 at Silchar Medical College and Hospital. All women were properly evaluated. Informed consent was taken and vaginal misoprostol tablets at a dose of 50 mcg 4 hourly was used to induce labour. The results were assessed. RESULTSIn a study of 100 women, mean natural age was 26.21 ± 4.98 years, mean gestational age was 38.81 ± 4.26 weeks, 61% women were primigravida and the rest were multigravida; 80% were booked cases, 72% belonged to rural areas and 76% were illiterates. The mean initial Bishop's score was 2.23 ± 1.82 (range 0 to 6), while following induction with misoprostol the mean Bishop's score was 6.98 ± 2.1, the mean difference was 4.75. P value was statistically significant. The mean induction-labour onset interval was 10 ± 6.65 hours and the mean induction-delivery interval was 13.60 hours with 46.46% women delivering within 12 hours. The mean misoprostol dose required was 152.5 ± 88.5 mcg. Induction was successful in all women, but laparotomy was needed in 1 women because of uterine rupture. The side effects noted were nausea (7%), vomiting (2%), diarrhoea (4%), fever (5%), uterine hyperstimulation (4%), ruptured uterus (1%), retained placenta (3%) and atonic post-partum haemorrhage (3%). CONCLUSIONMisoprostol is an effective, economic and safe drug that can be used for cervical ripening and labour induction in intrauterine foetal death. Clinical significance-the response to misoprostol is influenced by the gestational age, Bishop's score and parity of the women.

No abstract

BACKGROUND Acute abdomen during pregnancy is often worrisome for an obstetrician owing to the diagnostic and management challenges. A strong index of suspicion, clinical expertise and a multidisciplinary approach can go a long way to tackle such cases. The aim of this study is to analyse the presenting clinical features and the causes of acute pain abdomen during pregnancy and the management of such cases. MATERIALS AND METHODS A descriptive study was performed on 55 pregnant women presenting with acute pain abdomen admitted in Silchar Medical College and Hospital between July 2016 and June 2018. A detailed history and a thorough clinical examination was done. Women with labour pains were excluded from the study. The necessary investigations apart from the routine antenatal tests were carried out. Ultrasonography was performed in all. MRI was done when feasible or when diagnosis was unclear. Case management was individualised, and surgical and medical team involvement was made whenever needed. Surgical intervention was taken if indicated. All women were followed up. Data was analysed with Microsoft Excel. RESULTS 41.8%, 32.7% and 25.5% of the women were of the age group of 25 to 31 years, 18 to 24 years and 32 to 38 years respectively. 49.1% were Muslims, 20% were Hindus and 14.5% were Christians. 34.5% were booked cases. 81.8% were from rural areas. 36.4% of patients each presented with pain in the second and third trimester of pregnancy. The presenting symptoms were pain (100%), diminished appetite (45.5%), nausea (32.7%), bleeding per vagina (27.3%), increased urinary frequency (18.2%), backache (18.2%), shortness of breath (7.3%), diarrhoea (3.6%) and constipation (3.6%). In 89.1% women, pain was of less than 24 hours duration. 45.5%, 40% and 14.5% came with diffuse, lower and upper abdominal pain respectively. 87.3% complained of continuous dull pain, while 10.9% had intermittent, colicky pain. Anaemia (54.5%) and hypotension (49.1%) were the common associated findings. 29 (52.7%) cases were diagnosed to have an obstetrical cause of pain which included ectopic pregnancy (27.6%), miscarriage (20.7%), molar gestation (17.2%), ruptured uterus (17.2%), abruptio placentae (10.3%) and acute polyhydramnios (6.9%). In 26 (47.3%) cases the cause of pain abdomen was non-obstetrical which included acute appendicitis (19.2%), acute cholecystitis (15.4%), ureteric colic (15.4%), acute urinary tract infection (11.5%), acute pancreatitis (7.7%), intestinal obstruction (7.7%), acute peptic ulcer (7.7%), torsion of ovarian tumour (7.7%), blunt trauma with splenic rupture (3.8%) and red degeneration of uterine fibroid (3.8%). 82.8% of the women with obstetrical cause required surgical management. Amongst the 26 cases with non-obstetrical origin of pain, 8 (30.8%) underwent surgery-laparotomy (5) and laparoscopy (3). Significantly, higher number of surgeries were carried out in the second trimester (p < 0.05). The complications among women with non-obstetrical abdominal pain were-wound infection and preterm labour, amongst tho...