INTRODUCTIONPremature rupture of membranes at term (PROM) is defined as a spontaneous rupture of membranes after 37 completed weeks of gestation and before the onset of regular painful uterine contractions.1 PROM occurs in 5-10% of all pregnancies of which approximately 80% occur at term. 2 The aetiology of PROM is multifactorial. 2At term, PROM can be physiological variation rather than a pathological event. PROM occurs when intrauterine pressure overcomes membrane resistance.This happens due to weakening of membranes either congenital or acquired (smoking and vitamin C deficiency), or because of damaging factors either mechanical during amniocentesis or damage by infection (Trichomonas infection, group B streptococci, bacterial vaginosis). Failure of mechanical support such as cervical dilatation can lead to premature rupture of membrane. 3Other etiological factors are overdistended uterus, big baby, polyhydramnios and multiple pregnancy. Methods:The present study was a prospective randomised controlled trial, conducted on 100 term antenatal women with PROM in the Department of Obstetrics and Gynaecology, UPUMS, Saifai from January 2016 to June 2017. 50 antenatal women received immediate induction with oral misoprostol while another 50 antenatal women were expectantly managed for 24 hours. The latency period, PROM delivery interval, maternal and neonatal outcome were compared and subjected to statistical analysis. Results: 42% of active management group and 30% of expectant management group had a latency period of 12-20 hours and results were found to be statistically significant (p value = 0.005). There was no statistically significant difference in the rate of caesarean section, maternal and neonatal morbidity in both the groups. Conclusions: Immediate labour induction in patients with term PROM resulted in significant shortening of latent period and PROM to delivery interval without any increase in caesarean section rate as compared to expectant management group.

Introduction Anemia in pregnancy is a significant health challenge in India and other developing countries. Various health programs aiming anemia prevention are existing in India for many decades. Despite that, anemia affects more than half of pregnant women. Our objective for performing this study was to evaluate the barriers in the prevention of anemia and to evaluate the perceptions and practices of anemic women towards their condition. Methods A cross-sectional questionnaire-based study, including 210 anemic women, was conducted in a tertiary care center in Delhi, India. In-depth interviews were conducted with 50 participants. Results Our important observations were that anemia was more prevalent in multigravida, and 43.80% of anemic patients were not taking iron supplements at the time of diagnosis. Chronic diseases were associated with 28.2% (n=59) of anemic women. Only 19% (n=40) of women sought antenatal care in the first and second trimester; the rest all booked themselves in the third trimester only. Twenty-two percent (n=48) of women reached our hospital after 36 weeks. Ignorance to anemia symptoms and the importance of consistent intake of the oral iron supplements was seen in 35.2% (n=74). One hundred and sixty-five (74.8%) women accepted that healthcare provider had informed them about iron-rich and high protein diet, but only 47.1% (n=98) actually made dietary modifications. Only 9.5% (n=20) of women were consistent in iron intake. Side effects of iron were reported by 30% (n=64) of women, and 15% (n=32) were intolerant to oral iron. Non-availability, change of residence, and forgetfulness were the main reasons behind non-compliance to oral iron. Conclusion We emphasize motivation for early registration, regular antenatal care, adequate iron supplement supply, and persistent counseling to ensure compliance to iron supplements by the antenatal care provider. Behavior-changing communication is needed at a societal level for antenatal mothers and their families aiming to prevent anemia in pregnancy instead of focussing on treatment.

Aim: Present study is aimed at determining the analysis of transitional milk of post-natal non-anaemic mothers and its comparison with anaemic mothers in rural Uttar Pradesh. Methods: Totally, 132 post-natal cases were enrolled for the study. After taking ethical committee approval, breast milk samples were collected from day 4 to 11. We measured the following important parameters in breast milk (fat, density, carbohydrates, solid not fat [SNF], protein and added water). Data were analysed by using SPSS-24 software (IBM Corp., Armonk, NY). Tests used in our study were the analysis of variance (ANOVA) test, Chi-square test and independent T-test. Result: In our study, it was found that severe anaemia causes significant changes in fat, lactose and protein content of breast milk. We found that there are no significant changes in breast milk composition with age. Our study shows statistically no association between residence and breast milk content. Conclusion: As the severity of anaemia increases, protein and fat content in breast milk decreases, lactose content on the contrary follows a reverse relationship with maternal haemoglobin. Maternal anaemia not only affects the macronutrients in breast milk but also decreases the density of breast milk.

Background: Objective of the study was to assess the awareness and acceptance for contraceptive practices amongst the women attending the routine antenatal outpatient services at our tertiary rural institute.Methods: It was a cross sectional study done in UP University of Medical Sciences (UPUMS) Saifai. Three hundred fifty (350) patients aged between 18 -40 years were enrolled in the study after written informed consent. A self structured pre formed questionnaire was provided regarding demographic profile, obstetric profile, contraceptive practices and reasons for not using any contraception. Then data were analysed statistically.Results: Majority of the women were between the age group of 30-35 years and had basic level of education. In our study 90% women were aware of one or more methods of contraception. 86.5% accepted the contraceptive practices and 81.43% followed the contraception. 81.43% used temporary methods of which OCPs, IUCDs, and Condoms were common.Conclusions: Majority of the women were between 30-35 years of age. 90% women knew about some method of contraception. 81.4% women followed the temporary method of contraception. Among non users the main reason for not using contraceptive method were mainly lack of knowledge and they wanted more children.

Sirenomelia is a rare polymalformative, lethal congenital anomaly, characterized by fusion of both lower limbs, bilateral renal agenesis, absent external genitalia, aberrant fetal vasculature, and severe oligohydramnios. We hereby report a case of Sirenomelia diagnosed postnatally in an unbooked pregnancy presenting at the thirty-fifth gestational week.