BACKGROUND/AIMS:Menstruation is a normal part of adolescence, but for girls with excessive uterine bleeding, it can be associated with significant morbidity. Menstrual disorders and abnormal uterine bleeding (AUB) are among the most frequent gynaecological complaints of adolescents. AUB has been defined in the past by a variety of terms and there have been inconsistencies and lack of categorization of various potential causes of AUB. To have standard nomenclature internationally, palm coein Classification of AUB was introduced in 2011 by FIGO Menstrual disorder group for non-pregnant, reproductive age women. In the present study we aimed to evaluate cases of adolescent AUB by investigations and palm coein approach. METHODS: The study was conducted prospectively on all adolescent girls attending OPD at Krishna institute of medical sciences Karad, Menstrual complaints were classified according to palm coein approach after a thorough history taking, examination and investigations. RESULTS: Prevalence of menstrual disorders in adolescents was 64.5%, of which 86.90% were attributed to AUB. Palm coein approach was applied to AUB cases. Ovulatory disorders (AUB-0) formed a major chunk of adolescent AUB (96.90%), of which 60.60% were due to immaturity of Hypothalamic Pituitary Ovarian axis, 27.87% due to polycystic ovarian syndrome and 8.48% due to Thyroid disorders. Contribution of coagulopathy to AUB was 2.42%. Polyps and leiomyoma were seen in 1.2% and 0.6% of cases respectively. All cases were classified when palm coein was applied. CONCLUSION: AUB in adolescents can also be classified by palm coein to standardize nomenclature and abandonment of terms like menorrhagia, metrorrhagia and dysfunctional uterine bleeding and treated it successfully.

BACKGROUND HELLP is a rare life-threatening obstetric syndrome. It is a multisystemic complication of preeclampsia occurring in 0.1 to 0.8% of all pregnancies and in 10% to 20% of those with severe preeclampsia/eclampsia. This dreaded condition was traditionally associated with high rates of perinatal mortality over 70% and maternal mortality over 25%. However recent trends in early recognition and diagnosis, effective assessment and the rapid initiation of medical and obstetric critical care, all offer significant improvement in maternal and foetal prognosis. Aims and Objectives-To analyse the incidence, maternal and neonatal outcome of HELLP syndrome in a tertiary care teaching hospital serving a semi urban and rural population and to study management solutions to reduce maternal and perinatal mortality.

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A 25-years-old patient P2L2 married since 7 years with previous two LSCS came to OPD with chief c/o amenorrhoea since 4 months with nausea and vomiting with some hard mass felt in left side of abdomen since two weeks with pain in abdomen on-off since two weeks. She had regular menstrual cycles of 28-32 days with moderate flow.This was spontaneous conception. Without undergoing any ultrasound examination, she had undergone D&C 4 weeks back. 3 weeks after D&C due to persistent nausea and pain in abdomen she had checked her UPT which was positive.Abdominal pregnancy is a potentially life-threatening form of ectopic gestation with incidence of 1% of all ectopic pregnancies. Very rarely it may reach advanced gestation (1) with viable foetal outcome. Most of them are terminated earlier due to poor foetal outcome with higher chances of maternal morbidity and mortality. A high degree of suspicion for diagnosis and its timely management is of utmost importance in terms of saving life of a patients. CLINICAL DIAGNOSISOn examination she was conscious, oriented with pulse rate of 98 per minute. BP was 110/70 mmHg. Mild tenderness was present in the left iliac and lumbar regions. A mass was felt arising from pelvis and extending up to left lumbar region of around 20 weeks size and it was non mobile. On per speculum examination, cervix and vagina were normal with no bleeding or any discharge. On bimanual per vaginal examination, uterus was bulky ~10 weeks with tenderness in left fornix.Transabdominal USG revealed  e/o bulky uterus deviated to right side.  No e/o intrauterine gestational sac.  e/o left adnexal gestational sac implanted on pelvic peritoneum with live foetus of ~ 19 weeks.  Absence of myometrial tissue around gestational sac.  Placenta located on superior and lateral aspect of gestational sac. Baby weight 289 gms with AFI 13-14 cm.

This is a prospective randomized case control study to evaluate the role of 17 α hydroxyprogesterone caproate (17OHPC) in the prevention of preterm labor in high risk asymptomatic patients with a history of preterm delivery. METHODS: The study included 100 patients with a singleton pregnancy and having a prior preterm birth. They were divided in 2 groups, group I (treatment group) included 50 asymptomatic patients who were given 17OHPC injections starting from 18-24 weeks till 36 weeks and group II (control group) included 50 patients who did not receive any treatment. RESULTS: The incidence of preterm delivery was found to be 6.6%. The median gestational age at delivery was 36 weeks in group I and 34W5D in controls. 50% cases in group I and 80% of controls delivered prematurely in the group with a prior preterm birth between 20-28 weeks. Conclusion In patients who had a prior history of a preterm delivery the recurrence of a preterm birth was less in the treated group as compared to controls. The median gestational age at delivery was significantly higher in 17OHPC treated patients with history of earliest prior preterm delivery at 20-28 weeks.