Background: Healthy placenta is responsible for maintaining pregnancy and promoting normal foetal development. It reflects the intrauterine status of the foetus. Methods: In the present prospective study, total 50 Placentae from Medical Disorders of Pregnancies were studied and compared with equal number of Placentae from normal Pregnancies. Results: The significant macroscopic changes were calcification and infarction seen in Hypertensive Disorder. Extensive placental infarction was associated with high incidence of low APGAR (82%) and perinatal deaths (66.67%). No significant gross macroscopic changes were seen in Anaemia, Diabetes Mellitus and Heart Disease. Increased syncytial knots, fibrinoid degeneration, vasculo-syncytial membrane paucity were significant microscopic changes in Hypertensive Disorder. In Anaemia stromal fibrosis, increased syncytial knots were seen, whereas in Diabetes Mellitus villous edema was the most significant microscopic finding. No significant microscopic change was found in Heart Disease. Increased syncytial knots, fibrinoid degeneration, vasculo-syncytial membrane paucity, stromal fibrosis were associated with increased perinatal mortality. Conclusions: Gross and microscopic examination of placenta is strongly recommended in cases where maternal comorbid conditions is likely to have an adverse perinatal outcome.

Objective To compare the efficacy and safety of recombinant anti-D (R-anti-D) with conventional polyclonal anti-D (Poly anti-D) in preventing maternal-fetal rhesus D (RhD) alloimmunization and to investigate the immunogenicity of R-anti-D. Methods This was a randomized, open-label, multi-center clinical trial conducted in RhD-negative pregnant women who did not receive antenatal anti-D who delivered RhD-positive babies and showed negative indirect Coombs tests (ICTs) at baseline. The women were randomized in a 2:1 ratio to R-anti-D or Poly anti-D groups and were administered 300 mcg (IM) of the corresponding drug within 72 hours of delivery. ICT was performed 72 hours, 90 days, and 180 days after anti-D injection. Serum samples were collected to check for the development of antibodies against R-anti-D at days 90 and 180, using bridging enzyme-linked immunosorbent assay. The proportion of subjects who had positive ICT results at days 90 and 180 were compared between the groups using Fisher's exact test. Results A total of 144 women were randomized to the R-anti-D group and 71 to the Poly anti-D group. Three women in the R-anti-D and none in the Poly anti-D group had a positive ICT result at day 90. No woman in either group had positive ICT result at day 180. Both drugs were well tolerated with only 4 reports of adverse events in each group-all were mild, non-serious, and resolved without sequelae. No subject developed antibodies against R-anti-D. Conclusion The studied R-anti-D is comparable in efficacy to conventional Poly anti-D and is safe and non-immunogenic.

Background: Menopause is physiological stage in woman's life. Although most of women accept them, some do have a disturbed life due to various symptoms, mostly because of estrogen deprivation. Methods: This is a prospective clinical study of 200 menopausal women attending the gynaecology OPD or admitted in the wards with various symptoms as well as some gynaecological problems. Young women with surgically induced menopause and women with psychiatric disorders were excluded. Results: The duration between menopause and appearance of symptoms varied from 1yr to 10 yrs. The average age of menopause in our study was 46.5 yrs. Vasomotor symptoms (65%) were common followed by psychosomatic symptoms (62%), vaginal dryness (45%) and urinary symptoms (40%). Stress, irritability, sleep problem, weight gain were some of common presentations to OPD. Urinary incontinence and atrophic vaginitis were also seen predominantly. The management consists mainly of counseling and life style modification, exercise, yoga meditation etc. Some of the women required estrogen cream, 70 women required surgical treatment. Overall the response to various medications was satisfactory and on follow up the symptoms was found to be much less. Conclusions: There is need of setting menopausal clinics and centres to help women with symptoms and signs of estrogen deprivation. Counseling and education are main treatment modalities.

Background: Caesarean section rate is a qualitative health care indicator in India. With increasing rates of caesarean sections and no defined method to audit present institutes it is the need of the hour to use tools like Robson’s classification to understand present system. The aim of this study was to determine the rate and analyse Caesarean sections in a tertiary care institute using Robson’s ten group classification system.Methods: This is a retrospective analytical study in which all Caesarean section done over a period of 3 years (July 2014-June 2017) were included which were performed in single unit (out of 6) of Department of Obstetrics and Gynecology of Sassoon General Hospital. Women were classified in 10 groups according to Robson’s classification, using maternal characteristics and obstetrical history. For each group, authors calculated its relative size and its contribution to the overall caesarean rate.Results: Total deliveries were 4750 out of which 985 were Caesarean section, incidence was calculated as 20.7%. The main contributors to the overall Caesarean rate were primiparous women in spontaneous labour (group 1- {18.3%}) and women with previous caesarean section (group 5- {34.9%}).Conclusions: The Robson’s classification is an easy tool to use and identify the current changing dynamics in any hospital setup. Its implementation as an obstetric audit can help lower the Caesarean rates and improve the standards based on WHO criteria.

Scar endometriosis remains under diagnosed entity. A high index of suspicion is required for correct diagnosis. Complaints of pain, increase in size or bleeding from a mass post operatively that is cyclically associated with menstrual cycle is almost pathognomonic. Surgical excision remains the treatment of choice. We report three cases treated in our institute.