Background: Serum magnesium level in pregnancy is a valuable tool to find out preterm onset of labour. In the asymptomatic group, greater surveillance and administration of steroids, tocolytics and transfer to a higher centre wherever necessary has to be done with mothers with low serum magnesium level. The objective of the study is to find association between serum magnesium levels and women with preterm labour, and to compare these values with those patients who have a term delivery.Methods: The subjects included 100 pregnant women with preterm labour (cases) between 28 and 37 weeks gestation (Group A) and similar number of pregnant women with term labour (controls) between 37 and 40 weeks (Group B). Inclusion criteria for cases was singleton pregnancy, painful uterine contractions more than two in 30 minutes, intact fetal membranes, cervical dilatation (at least 1 cm) and effacement (80%). Serum magnesium levels were done in both the groups. Patients were followed until delivery. Routine antenatal investigations were done. Serum levels of magnesium were estimated by Erba’s semi auto-analyser.Results: 62% patients in Group A were from rural areas. More patients in Group A (70%) were from low socioeconomic class. More women in Group A were anaemic (44%). Mean value of hemoglobin in Group A was 9.93gm/dL. More patients in Group A had muscle cramps (89%). VLBW (<1500gm) neonates were more in Group A (21%). Also, LBW (1500-2499gm) neonates were more in Group A (60%). Mean neonatal birth weight in Group A (1907.3gm) was less. Neonatal morbidity and mortality was observed significantly more in Group A. Mean serum magnesium was less in Group A. Mean serum magnesium levels in primi and multigravida patients were less in Group A. Moreover, mean serum magnesium levels were less in urban and rural patients in Group A. Mean serum magnesium levels were less in normal and overweight patients in Group A. Also, mean serum magnesium levels were less in patients with cervical dilatation <3cm and >3cm in Group A.Conclusions: Low maternal serum magnesium level is associated with preterm labour. Patients with preterm labour have significantly low serum magnesium level when compared with labour at term.

Background: Pelvic organ prolapse is common in women and 7-9% undergo surgical repair. Abdominal sacrocolpopexy and sacrohysteropexy is the most durable operation for vault prolapse and Nulliparous prolapse respectively. The objectives of this study were to describe Anatomic and symptomatic outcomes up to 5 years after abdominal sacrocolpopexy or sacrohysteropexy.Methods: This study was conducted in ASCOMS hospital for a cohort of patients who underwent abdominal sacrocolpopexy (ASC) or sacrohysteropexy (ASH) in 2 years (2013-2015) and follow up done for a period of 5 years from 2015-2019. These patients were evaluated for subjective and objective outcomes following ASC and ASH. women completed questionnaires and were examined in gynaecology clinic. Prospective follow up study using standarised examination with pelvic organ prolapse quantification system (POP-Q) and questionnairesResults: In the present study, there was low incidence of intraoperative and postoperative complications as well as long term complications were significantly low. The anatomical cure rate and patient satisfaction rate was both 100%.Conclusions: Abdominal sacrocolpopexy for vault prolapse and sacrohysteropexy for Nulliparous prolapse is safe and effective method and is considered gold standard for treatment of Apical compartment prolapse.

Background: Serum magnesium level in pregnancy is a valuable tool to find out preterm onset of labour. In the asymptomatic group, greater surveillance and administration of steroids, tocolytics and transfer to a higher centre. In this study, low maternal serum magnesium level was associated with preterm labour. The values were also lower in women with low socio-economic status.Methods: The subjects included 100 pregnant women with preterm labour (cases) between 28 and 37-week gestation (group A) and similar number of pregnant women with term labour (controls) between 37 and 40 weeks (group B). Inclusion criteria for cases was singleton pregnancy, painful uterine contractions more than two in 30 minutes, intact fetal membranes, cervical dilatation (at least 1 cm) and effacement (80%). Serum magnesium levels were done in both the groups. Patients were followed until delivery. Routine antenatal investigations were done. Serum levels of magnesium were estimated by Erba’s semi auto-analyser.Results: 62% patients in group A were from rural areas. More patients in group A (70%) were from low socioeconomic class. More women in group A were anaemic (44%). Mean value of hemoglobin in group A was 9.93 g/dl. More patients in group A had muscle cramps (89%). VLBW (<1500 g) neonates were more in group A (21%). Also, LBW (1500-2499 g) neonates were more in group A (60%). Mean neonatal birth weight in group A (1907.3 g) was less. Neonatal morbidity and mortality were observed significantly more in group A. Mean serum magnesium was less in group A.Conclusions: Low maternal serum magnesium level is associated with preterm labour. Patients with preterm labour have significantly low serum magnesium level when compared with labour at term. The values were also lower in women with low socioeconomic status.

To correlate hysteroscopic findings with histopathologic findings and study the accuracy of hysteroscopy in evaluation of abnormal uterine bleeding. Methods: This prospective study was conducted at Tertiary care hospital, Department of Obstetrics and Gynaecology SMGS GMC Jammu, from July 2019 to Feb 2020. 100 patients who were admitted with history of abnormal uterine bleeding were selected for this study. Reproductive aged, perimenopausal and postmenopausal females with age between 25-70 years were included while pregnant females, females with clinically palpable pelvic pathology, unhealthy cervix and coagulation disorders were excluded from this study. All patients underwent Hysteroscopy and D&C postmenstrually with consent. The hysteroscopic and histopathologic findings (after D&C) obtained were compared. Results: This study was conducted on 100 patients of age group between 25-70 years, with mean age 41.2 years. Menorrhagia (35%) was the commonest presenting symptom. Diagnostic efficacy of hysteroscopy in terms of accuracy 84.6% for proliferative endometrium, 84.46% for secretory endometrium, 89% for hyperplasia, 100% for polyp, 100% for myoma, 100% for endometrial CA respectively. Conclusion: Diagnostic accuracy of hysteroscopy was found better in polyps and submucous myomas which were missed by traditional D&C. Although the diagnostic accuracy of pathological abnormalities in our study was 75%, hysteroscopy has 100% accuracy for CA endometrium, Myoma and polyp. Hysteroscopically directed biopsy would be an ideal procedure in abnormal uterine bleeding wherever facilities are available.

Background: Misoprostol use in early pregnancy failure is varied and dose is not well established. Aim of this study was to compare efficacy and side effects of 600 versus 800 micrograms vaginal misoprostol in early pregnancy failure.Methods: A randomized prospective observational study was conducted in the postgraduate department of obstetrics and gynaecology, SMGS hospital Jammu from November 2018 to October 2019 after getting approval from the ethical committee. Hundred patients (50 in group A and 50 in group B) admitted in labour room before 12 weeks of gestation with an ultrasound diagnosis of early fetal demise (missed abortion or brightened ovum) were treated medically with different doses of vaginal misoprostol.Results: The success rate in patients in group A is 72% and group B is 88%, p=0.045 (difference is statistically significant). Patients who required suction and evacuation were 28% in group A and 12% in group B.Conclusions: Use of misoprostol for medical management of 1st trimester missed/anembryonic is an effective, cheap, safe and convenient alternative to surgical evacuation. It was concluded that 800 micrograms vaginal misoprostol is more effective than 600 micrograms vaginal misoprostol. But 800 micrograms misoprostol has more side effects than 600 micrograms vaginal misoprostol.