Background: Several models have been proposed to predict the need for an LSCS. With reference to this, the impact of the size of the fetal head traversing the birth canal is an important determinant of delivery outcomes. We examined the association between the head circumference and mode of delivery and perinatal outcomes, when compared to birth weight predicted by scan.Methods: This was a retrospective study, on 800 electronic delivery records between December 2019 and May 2021. Sociodemographic data, obstetrical parameter, term scan findings of head circumference and estimated fetal weight, and labour and perinatal outcomes were collected and analysed.Results: HC >95th centile was found to be comparatively more predictive and statistically significant compared to EFW >95th centile in the prediction of LSCS, with the most common indication being cephalopelvic disproportion. Prolonged second stage of labour was statistically significant in both cohort A and B, undergoing vaginal delivery. It was also noted that a significant number of newborns in cohort A required NICU admissions, while NICU admissions after emergency LSCS was significantly higher in the cohort B (p=0.0032) though the overall 5 and 10 minute APGAR scores and duration of stay were comparable in the groups classified on basis of EFW and HC.Conclusions: The above statistics observed on an Indian population may aid obstetricians in the planning of the mode of delivery, improve pre-labor counselling and efficient management of mothers of large babies.

Background: Post partum period is an extremely exigent chapter requiring immense adaptations from a mothers' personal and familial circle. Post partum depressiona morbidity that could start soon after child birth has long term implications on the health of the mother and her new born. Its estimated prevalence in India according to the WHO bulletin 2017 has been 22%. The hassle caused by COVID 19 pandemic, has overturned the life of some, displaced few and affected most of us. The study strives to assess the impact of COVID 19 pandemic on the psychological status of postnatal mothers delivering at our hospital. Methods: This is a hospital based cross-sectional study conducted on 80 post natal mothers who delivered during the COVID 19 pandemic. The participants were given a questionnaire consisting of 3 parts-Isociodemographic and parturition details, II-to analyse the impact of the pandemic, III-Edinburg Postnatal Depression scale questionnaire. Data collected was compiled, and analysed using percentages, and Chi square test was used to test the significant difference in the possible risk factors for the different levels of depression.Results: This study has shown that 28.75% of the mothers fell in the category of moderate depression and that women less than 25years were more prone to psychological distress. The burden of anxiety and PPD was more in women with lower educational and socioeconomic status. The pandemic adversely affected both the employed and unemployed women to an equal extent with nearly 65% of mothers claiming to have suffered significant monetary loss. Primigravidas and mothers who underwent operational delivery were more prone to PPD. Conclusions: Our study shows that nearly 28.75% of the participants suffered from moderate depression and this higher percentage of PPD can be attributed to the ongoing stressor-the COVID 19 pandemic. Thus it becomes essential for the treating obstetrician to collobrate with a psychiatrist to reach out and offer routine screening and timely support to the affected mothers at these crucial times.

Background: Breastfeeding plays a crucial role in the general health and wellbeing of infants. However, this fact has been made to look inconsequential due to various misconceptions and lack of adequate knowledge among lactating mothers. The aim of this study was to assess the knowledge, attitudes and practices of breastfeeding among postnatal women in Dakshinakannada district of Karnataka, India. The objective was to educate them and encourage breastfeeding.Methods: This study is a cross-sectional survey conducted during a period of 2 months from November to January 2019 among 80 postnatal mothers regarding their KAP of breastfeeding. A questionnaire was designed from FAO guidelines for assessing nutrition-related knowledge, attitudes and practices manual and The Iowa Infant Feeding Attitudes. The data was collected by a single interviewer, collaborated into a 3-point Likert scale and analyzed using descriptive statistics.Results: The study shows that 81.25% of the mothers had good knowledge regarding breastfeeding, but the alarming finding was that 46.6% of them had a neutral attitude towards it.Conclusions: The study showed that there is significant possibility for enhancing breastfeeding practices among lactating mothers by simple provision of supportive prenatal and postnatal counselling. The role played by healthcare workers in this context would be very imperative to accomplish millennium development goals of reducing infant mortality.

Background: Birth canal lacerations include the injuries to cervix, vagina or perineum. Those of the perineum often follow vaginal delivery, and most are first-and second-degree lacerations. Third- and fourth- degree lacerations are considered Obstetrical anal sphincter injuries (OASIS), and their combined incidence varies from 0.5-5%. Risk factors for these more complex perineal injuries have been studied. One important risk factor includes the length of the perineal body which plays an important role in determining the degree of perineal tears. The aim of the study was to assess the relationship between perineal body length and other characteristics, and occurrence of perineal lacerations during delivery in low risk primigravidae in an institution which advocates routine episiotomy for primigravidae.Methods: This was a prospective observational study carried out in the department of obstetrics and gynaecology at AJ Institute of medical sciences among primigravidae who met the selection criteria and delivered between September 2021 and November 2021. A total of 80 women were recruited in this study. In this study, we measured the perineal body length at rest, while the patient was in a dorsal lithotomy position during 1st stage of labor, after delivery the new born’s weight and head circumference were noted. The duration of second stage was noted. These parameters were studied in relation to the occurrence of perineal lacerations and the data was analysed.Results: In the present study it was noted that 10 participants (12.50%) had 3rd degree perineal tears and none had 4th degree perineal tears. With the perineal body length cut off of 3 cm, the sensitivity to predict 3rd and 4th degree perineal tears were found to be 80%, specificity of 90%, positive predictive value of 53.33% and a negative predictive value of 96.92%. The study concluded that a shorter perineal body length, was associated with the occurrence of a 3rd or 4th degree tear, p value of less than 0.00001. The study also showed increased incidence of higher degree perineal tears with higher birth weight and head circumference of the newborn with p value of 0.015 and 0.02 respectively.Conclusions: It can be concluded that Perineal body length of less than 3 cm, higher birth weight and head circumference is associated with an increased incidence of higher order perineal tears. Perineal body length hence has a good ability to predict the occurrence of perineal tears.