BACKGROUND Obstetric cholestasis is a disorder of liver function commonly occurring in the third trimester of pregnancy. Clinical characters of this disorder include unexplained maternal pruritus, most common site being palms and soles, altered liver functions (elevated serum transaminases) and increased fasting serum bile acids (>10 micro mol/L) in previously healthy pregnant women. The incidence is variable geographically from 0.1% to 15.6% all over the world. The aetiology of this condition is not fully understood. Its pathogenesis is related to increased sex hormone synthesis, environmental factors and genetic predisposition. Obstetric cholestasis can lead to increased foetal morbidity and mortality with regards to preterm delivery, neonatal respiratory distress syndrome, foetal distress and sudden intrauterine foetal death. Treatment of the disease focus on relieving symptoms and signs. The aim of the study is to evaluate the pregnancy and foetal outcome of pregnant women with obstetric cholestasis. MATERIALS AND METHODS A cross-sectional study was conducted in M.K.C.G. Medical College and Hospital, Berhampur from February 2015 to May 2017. Inclusion Criteria-All patients having pruritus during course of pregnancy with biochemical evidence of raised liver function tests attending antenatal clinic or labour room. Exclusion Criteria-1) Pregnant women without pruritus; 2) Pregnant women having other liver diseases. RESULTS The incidence of obstetric cholestasis was 0.6%. Majority of cases were primigravida (72.9%). Positive family history was present in 11.4% of cases. Majority of cases (77.1%) had normal vaginal delivery. 22.9% of cases had caesarean section. Primary postpartum haemorrhage occurred in only 2.9% of cases. CONCLUSION Obstetric cholestasis can be managed by improving the circulating bile acid level, targeting the cause of pruritus and optimising the time of delivery as a result of which we can reduce adverse pregnancy outcomes.

BACKGROUND Vaginal route of hysterectomy is being reinvented as a part of enhanced recovery with advantages of reduced operating time, lesser hospital stay, reduced morbidities and better patient satisfaction as scarless surgery. The aim of our study was to evaluate the safety and feasibility of non-descent vaginal hysterectomy. MATERIALS AND METHODS In this study, 78 cases with uterine size from normal to 18 weeks selected and operated after complete evaluation with valid consent. Operating time, blood loss, duration of hospital stay, intraoperative and postoperative complications were noted. Patients were followed up after two and six weeks. RESULTS The commonest age group in the study was 41-45 years (58.97%). Most common indication of hysterectomy was fibroid uterus (61.53%). The average operating time was 62 minutes with average blood loss of 220 mL and average hospital stay of 3-4 days. Only 2 cases developed major complications. One had primary haemorrhage requiring laparotomy, other developed ureterovaginal fistula requiring further surgery for repair. CONCLUSION NDVH is feasible, safe and can also be utilised for enlarged uterus upto 18 weeks, but descent and mobility of uterus, adequate vaginal space, uterine dimensions in both antero-posterior and transverse directions should be taken into account before contemplating NDVH.