Background: Breast milk contains balanced nutrients for the complete growth of body and brain of neonates and infants. Breast feeding is rich in anti-infective factors and improves immune system, thus reducing the child mortality rate. Objective of present work was to study the effect of antenatal breast milk expression at term in improving lactational performance as compared to control group.Methods: The prospective, comparative study was conducted for 2 years to observe effects of antenatal expression of breast milk on postnatal lactational performance in a tertiary care centre   in Central India.  200 Subjects after 37 weeks of pregnancy divided in two groups of 100 each 1) study group 2) control group by systematic random sampling technique. Prior examination was done to exclude any inverted or cracked nipples and appropriate treatment instituted. The women with diseased breast and conditions, high risk pregnancy, congenitally anomalous fetus and drugs affecting lactation were excluded from study. Study group women were counselled to express milk 2-3 times every day preferably during bathing. All women were followed up in hospital and postnatal lactation performance was observed in both groups.Results: The study group did not find it difficult to initiate breast feeding after vaginal or caesarean delivery  and in 78% of patients time interval from initiation of lactation to establishment of lactation was less than half hour as compared to control group (38%) P value <0.001. Statistical analysis showed significant difference in the results of those groups.Conclusions: Daily antenatal breast milk expression after 37 weeks of pregnancy significantly reduced the time for establishing full breast feeding and reduced breast feeding failures.

Background: Hysterectomy is the most common operation performed by the gynaecologist. The uterus can be removed using any of the technique and approaches, including abdominal, vaginal, laparoscopic. There are no formal guidelines available regarding the most appropriate route of hysterectomy. Hence, a comparison of the clinical results of the three routes of hysterectomy is needed.Methods: a prospective study was performed at Indira Gandhi government medical college Nagpur between September 2015- October 2017, among 150 women indicated to undergo hysterectomy for benign and mobile uterine conditions. They were assigned 50 each to three routes of hysterectomy (abdominal, non-descent vaginal hysterectomy and Laparoscopic assisted vaginal hysterectomy). Outcome measures including operating time, blood loss, fall in haemoglobin, intra-operative complications, duration of analgesia, VAS score, hospital stay and post-operative morbidity were assessed and compared between the three groups.Results: Fibroid uterus (65.33%), was the commonest indication for hysterectomy. As far as operating time, intra-operative blood loss, fall in haemoglobin, duration of analgesia, VAS score and hospital stay P Value was significant among the three group. Incidence of complications was least in the NDVH group.Conclusions: In developing country like India with poor health care resources, scarcity of beds and non-availability of sophisticated equipment NDVH offers a distinctive advantage over other route of hysterectomy and should be the route of choice for benign uterine conditions.

Background: Preeclampsia occurs in presence of placenta. Blood supply distribution within the uterus is not similar in central versus lateral sites implicating that, the site of placenta is likely to have a profound effect on the pregnancy outcome. In the light of these observations, a prospective study was designed to find out if the lateral location of placenta as seen by ultrasound between 18-24 weeks of gestation can be used to predict the development of preeclampsia.Methods: This prospective study was conducted in the department of Obstetrics and Gynaecology in IGGMC, Nagpur between January 2017 and June 2018. Pregnant women, with singleton pregnancy and without any risk factor, attending the antenatal clinic were subjected to USG between 18-24 weeks of gestation. Accordingly, patients were divided into 2 groups, 51 with lateral placenta and 51 with central placenta. All 102 women were followed till term. The end point of the study was development of preeclampsia i.e. BP >140/90 and urine albumin >300 mg in 24 hours sample. The data obtained was analysed using appropriate statistical tests.Results: Out of 102 patients, 80.9% were from lateral placenta group and only 19.1% were from central placenta. Sensitivity of this as screening test for preeclampsia was 80.9% while specificity was 58%, Odds ratio being 5.875. In predicting preeclampsia, lateral placenta had a meaningful effect with p value <0.001.Conclusions: Placental laterality, as determined by USG between 18-24 weeks of gestation, is a simple and cost-effective screening test for development of preeclampsia.

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