A 25-years-old patient P2L2 married since 7 years with previous two LSCS came to OPD with chief c/o amenorrhoea since 4 months with nausea and vomiting with some hard mass felt in left side of abdomen since two weeks with pain in abdomen on-off since two weeks. She had regular menstrual cycles of 28-32 days with moderate flow.This was spontaneous conception. Without undergoing any ultrasound examination, she had undergone D&C 4 weeks back. 3 weeks after D&C due to persistent nausea and pain in abdomen she had checked her UPT which was positive.Abdominal pregnancy is a potentially life-threatening form of ectopic gestation with incidence of 1% of all ectopic pregnancies. Very rarely it may reach advanced gestation (1) with viable foetal outcome. Most of them are terminated earlier due to poor foetal outcome with higher chances of maternal morbidity and mortality. A high degree of suspicion for diagnosis and its timely management is of utmost importance in terms of saving life of a patients. CLINICAL DIAGNOSISOn examination she was conscious, oriented with pulse rate of 98 per minute. BP was 110/70 mmHg. Mild tenderness was present in the left iliac and lumbar regions. A mass was felt arising from pelvis and extending up to left lumbar region of around 20 weeks size and it was non mobile. On per speculum examination, cervix and vagina were normal with no bleeding or any discharge. On bimanual per vaginal examination, uterus was bulky ~10 weeks with tenderness in left fornix.Transabdominal USG revealed  e/o bulky uterus deviated to right side.  No e/o intrauterine gestational sac.  e/o left adnexal gestational sac implanted on pelvic peritoneum with live foetus of ~ 19 weeks.  Absence of myometrial tissue around gestational sac.  Placenta located on superior and lateral aspect of gestational sac. Baby weight 289 gms with AFI 13-14 cm.

Women after delivering her first baby by section have a choice about mode of delivery for her second baby. The study was planned to compare maternal and perinatal outcome between VBAC and repeat elective LSCS in patients with prior one LSCS and their complications. A prospective observational study was carried out in department of obstetrics and . Total 180 cases of previous LSCS who were eligible for vaginal delivery were recruited 90 in each group as per consent given by them. Group 1: Vaginal Birth after section Group 2: elective repeat section. It was observed that majority of the patients group 1(51.1%) and group 2 (47.8%) were in age group of 25 to 30 years. More than 25kg/m2 BMI was found in 18(20%) cases of VBAC group and 30(33.3%) cases of LSCS group pregnancy interval was significantly lower in LSCS group compared to VBAC group. Mean birth weight was 2.832 kg to 2.917kg in both group. with improved maternal care, close fetal monitoring and institutional delivery for a previous one section, VBAC is considered safer than repeat elective section in carefully selected patient.