BackgroundDisorders of sex differentiation (DSD) are very important issues in clinical practice, particularly because of their rarity and difficulty pertaining to their diagnosis and management. Persistent Mullerian duct syndrome (PMDS) is a form of disorders of sex differentiation (DSD) caused by a defect in the Mullerian inhibiting substance (MIS) system. Patients are genotypically as well as phenotypically male but with the presence of Mullerian duct derivatives [1]. This entity is often misdiagnosed due to a lack of familiarity with the condition and requires a high B. Kalpana MD (O&G), FNB (Rep. Medicine), FICOG, FIAOG

Background: The common reason for rise in elective Caesarean Section (CS) rate among primigravidas is maternal request due to labor pain fear. Many non-pharmacological pain relief strategies are available to help women cope with labor pain, providing a positive and satisfactory birth experience. The objective of this study was to evaluate effects of KT and Acu-TENS on maternal and neonatal outcomes in primigravidas.Methods: 40 full-term primigravidas with an age range of 20-40 years were enrolled into the study by convenience sampling method and divided into 2 groups. Group A received KT and Group B received Acu-TENS. Both groups received breathing exercises. Pain assessment at various cervical dilatation levels were carried out for all participants before and after treatment using Visual Analogue Scale (VAS). Duration of active phase in first stage labor, mode of delivery and neonatal well-being were measured following delivery.Results: Group A experienced VAS score reduction significantly more than Group B, p=0.004; <0.05. There was no significant change in active phase duration of first stage labor between Group A and Group B, p=0.319; >0.05. CS rate was increased in Group A [35% (7/20)] than in Group B [25% (5/20)], but neonatal outcomes were not different.Conclusions: This study proves that KT produced significantly better pain relief than Acu-TENS in first stage labor among primigravidas. Acu-TENS showed reduction in active phase duration of first stage labor than KT. Both interventions can safely be used non-invasively for labor pain relief.