Pregnancy is a physiological phenomenon for most women. However, some develop problems during its evolution, putting both the mother's and the conceptus' health at sake. Pregnancy-induced hypertension is one of the maternal diseases that cause the most detrimental effects to the maternal, fetal, and neonatal organisms. Pregnancy-induced hypertension is the general classification for hypertension diseases during pregnancy, which include pregnancy-induced hypertension (without proteinuria), preeclampsia (with proteinuria), and ABSTRACT Background: Pregnancy Induced Hypertension (PIH) is one of the common conditions of unknown etiology which increases risk of maternal and perinatal morbidity and mortality. Objectives: To study the maternal and perinatal outcome in pregnancy induced hypertension. Methods: A prospective study was carried out from February 2014 to January 2015 in the Department of obstetrics and gynecology of GMERS medical college and hospital, Dharpur-Patan, North Gujarat, India. A total of 95 pregnant women with PIH were enrolled in the study. A pre-tested interview tool was used to collect necessary information such as detailed history, clinical examination findings and investigations performed. Results were analyzed using SPSS 17.0 (Trial Version). Results: In the present study, the overall incidence of PIH was 12.8%, which includes preeclampsia in 11.4% and eclampsia in 1.4%. Out of total 95 cases, 69 (72.6%) were emergency cases. 72 (75.7%) cases were from rural area. The most common symptoms were labour pains (48.4%) followed by eclampsia (11.5%). 51 (53.7%) women delivered normally. Eclampsia was the commonest maternal complication affecting 11.6% of cases. Out of total 95 births, perinatal deaths were occurred in 22 (23.15%) cases. Out of 22 perinatal deaths, 13 (61.2%) were still births and 9 (42.8%) were neonatal deaths. Conclusions: Pregnancy induced hypertension is a common medical disorder seen associated with pregnancy especially among young primigravidas, who remain unregistered during pregnancy. Maternal and fetal morbidity and mortality can be reduced by early recognition and institutional management.

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INTRODUCTIONPostpartum period is a very vulnerable period both for women and infant. Initiation of contraception during this period is important to prevent unintended pregnancy and short birth intervals. It can avert more than 30% of maternal deaths and 10% of child mortality. Pregnancy occurring within six months of the last delivery holds a 7.5-fold increased risk for induced abortion and a 1.6-fold increased risk of stillbirth.In a recent study of postpartum unintended pregnancies 86% resulted from non-use of contraception and 88% ended in induced abortions.1 continuation of these pregnancies is also associated with greater maternal complications and adverse perinatal outcomes. In India 65% women in the first year postpartum have an unmet need for family planning. Contraception method by definition mean to prevent unwanted pregnancy. According to WHO, Medical Eligibility Criteria, an IUD can be inserted in 48 hours postpartum referred to here as PPIUCD.2 A 2010 cochrane review concluded that PPIUCD are a safer and effective contraceptive method.3 Healthy timing and spacing of pregnancies have a positive effect on maternal health and newborn outcome. 4 IUCD are used by only two percent of current users of contraception in India.5 A subsequent study suggested that 65% of women in the 1 st ABSTRACT Background: Evaluation of PPIUCD in terms of incidence of failure, expulsion, bleeding p\v and other complication. Present study is aimed at determining the safety, efficacy, expulsion of post placental and intra cesarean insertion of intrauterine device. Methods: Prospective analysis was carried out to collect information regarding IUCD insertion and outcome at tertiary care center for the period of three years using the hospital record that a total number of 600 mothers had postpartum intrauterine contraceptive device. Results: Total women opted for PPIUCD 600, Followed up 560 after 1 week, 580 after 6 weeks and 400 after 6 months. Complications after 6 months 228. (pain 66, bleeding 37, expulsion 17, strings problem 7, discharge p/v 101). Conclusions:The insertion of PPIUCD is safe and effective method of contraception in the means of complication though it is a new concept for the population it is well accepted by the community though expulsion rate is somewhat high compare to conventional IUCD. it can be reduced with practice.

INTRODUCTION Ectopic pregnancy is a pregnancy in which fertilized ovum implants other than the endometrial lining of the uterus. In 95% of EPs, fertilized ovum implants in the tubes, but rarely in other organs like abdomen, ovaries, cervix, spleen, omentum, caesarian section scar, and intramural. The risk factors for EP include pelvic inflammatory disease, previous tubal surgery, previous tubal pregnancy, progestin contraceptive, assisted reproduction, ovulation induction, induced abortion, salpingitis isthmica nodosa, smoking, and diethyl stilbestrol exposure. 1,2 Most of the tubal pregnancies become symptomatic within 12 weeks, but a small ABSTRACT Background: Ectopic pregnancy is assuming greater importance because of its increasing incidence and its impact on woman's fertility. Objective: To study the clinical profile and management of ectopic pregnancies. Methods: This prospective study was conducted over one year from 1 st January 2013 to 31 st December 2013 for risk factors, mode of presentation, status at admission, diagnostic and treatment modalities and management of patients with ectopic pregnancy. Results: Over all mean rate of ectopic pregnancy has been found 11.41/1000 births. Out of total 52 cases 32 (64%) were referred while 20 (36%) were emergency cases. Out of 52 patients, 23 (44.23%) were from urban areas and 29 (55.77%) were from rural areas. Majority of the patients (51.97%) were in 26-30 years age groups. Gravida 3 had highest incidence (30.76%) of ectopic pregnancy. Maximum (50%) ectopic pregnancies were found in women with active married life of 5-10yrs. Out of total 52 cases, 44 (84.62%) were ruptured ectopic pregnancy cases. Ampulla was the most common site for tubal ectopic pregnancy (51.92%). Abdominal pain was the most common presenting symptoms (92.30%) followed by amenorrhoea in 84.61% cases. Majority of patients had history of infertility (42.30%) as a major risk factor. Laparoscopic management was done in 13 (25%) patients out of them lap. salpingectomy was done 9 (17.31% of total) and lap. Salpingostomy was done in 4 (7.69% of total) patients. Conclusion: Although ectopic pregnancy will never be completely prevented, but incidence can be reduced and much of the morbidity and mortalities can be minimised by prevention and efficacious diagnostic and interventional strategies aimed primarily at those women who are at high risk for the condition and taking precaution that woman who likely to become high risk are handled in such a way that the number of these high risk women are reduced.

Preeclampsia is rise of blood pressure more than or equal to 140/90 mmHg recorded on two occasions 6 hours apart with Proteinuria (0.3 gms or more protein in 24 hour collected urine sample with 1+ or greater on urine dipstick test) after 20 weeks of gestation involving multiple organ systems. ABSTRACTBackground: Placental abnormality is one of the initial events seen in patients who are destined to develop preeclampsia . The objective was to study whether ultrasonically identified; placental laterality and uterine artery resistance can be used as a predictor for development of preeclampsia. Methods: This prospective observational study was conducted at GMERS Medical College, Dharpur-Patan tertiary care teaching institute in North Gujarat from January 2013 to December 2014. A total 400 non high risk primigravida with singleton pregnancy were included, all patients with diabetes, hypertension, renal disease, and history of smoking were excluded. In all these patients, location of placenta was determined by ultrasonography at 18 to 22 weeks of gestation. Patients who had lateral placenta were subjected for colour Doppler study for determining uterine artery resistance index. All 400 patients were followed till delivery for occurrence of preeclampsia as per ACOG guidelines. All data was analyzed and statistical significance was determined by x 2 test and value of p<0.05 is considered significant. Results: Out of 400 cases, 80 (20%) cases had laterally located placenta on ultra sound examination done at 18 -24 weeks of gestation. Out of the 80 women with laterally located placenta, 28 (35%) developed preeclampsia. This relationship was statistically significant. All 80 patients who had lateral placenta, 26 patients had raised uterine artery resistance and out of those 26 patients, 22 developed preeclampsia and 54 had no chang e in uterine artery resistance. Out of those 54 only 6 had preeclampsia (p<0. 001). The sensitivity of determining uterine artery resistance as a predictive test was 84.6%, the specificity 88.8 %, positive predictive value 78.5 % and negative predictive value 92.3%. Conclusion: A chance of preeclampsia is more in patients with lateral placenta but its sensitivity and specificity increases significantly when it is combined with uterine artery velocimetric waveform study, and we can predict preeclampsia in patient who is having lateral placenta and raised uterine artery resistance.