INTRODUCTIONThe essential components of antenatal care are screening of pregnant women for high risk factors, performing essential laboratory investigations and provision of advice regarding personal hygiene, nutrition, immunization and regular follow up visits. Literature review suggests that women with regular antenatal visits have better pregnancy outcome than their counterparts. 1The reported percentage of antenatal care coverage in India by UNICEF was 37% for four visits and 74% for at least a single visit (2014), institutional delivery rate of 47% and delivery by trained person was 52%.2 Despite ongoing efforts to improve maternal and child health in developing countries, mortality rates remain much higher than in developed countries.3 Women in developing ABSTRACTBackground: The rapid escalation of cellular network coverage and expansion of mobile phone usage has opened up a new way of deploying health services. The mobile app with message facilities help in imparting health education regarding nutrition, iron and folic acid prophylaxis, tetanus toxoid immunization, danger symptoms and signs during pregnancy etc. Present study aimed to improve maternal health and pregnancy outcome by optimum utilization of antenatal, natal and postnatal care services, with the use of mobile phone as a medium of communication between health care provider and community in rural area. Methods:The prospective randomized control study, with two hundred pregnant women each, coming for antenatal visit and having personal mobile phone facility, were randomly allocated to control and intervention group. Control group women received routine antenatal care and advice as per hospital protocol. In addition to routine care and advice, intervention group received mobile phone calls, as reminders about next visit and text messages (SMS) on important aspects of antenatal care at regular intervals. The primary outcome indicators of the study were percentage of pregnant women coming for at least four antenatal visits, percentage of institutional delivery and postnatal checkups. Results: Women in the intervention group had significantly higher number of antenatal visits, consumption of iron tablets, tetanus toxoid immunization, institutional deliveries and postnatal check-ups as compared to the control group. Conclusions: In the present study, the mobile phone intervention, significantly increased the percentage of women receiving the recommended four antenatal visits and showed a trend towards more women receiving preventive health services. Study gathered good evidence that m-Health tools present an opportunity to influence behaviour change and ensure that women access prevention services, including antenatal, natal and postnatal care. Mobile technology, specifically SMS can be successfully used to extend health information services to pregnant women.

Background:The rate of primary cesarean section (CS) is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS.Aims:The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC) in selected cases of one previous lower segment CS (LSCS).Materials and Methods:The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study.Results:In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality.Conclusion:Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.

Background: Obstetric emergencies occur suddenly and unexpectedly. Blood transfusion becomes one of the live saving measures in such situations. Severe anaemia due to nutritional deficiency, obstetric haemorrhage either during pregnancy, labour or in postpartum period are the commonest indications for blood transfusion worldwide. Blood bank services play important role in saving lives in obstetric emergencies. Health institutions must carry out internal blood transfusion audits to reassure optimal and judicious use of blood and blood components.Methods: Analysis of 755 Obstetric patients requiring blood transfusion in eighteen months period was done to find out the incidence and indications for blood transfusion at tertiary care hospital.Results: Overall, 5.33% of obstetric admissions required transfusion of blood or its components. Severe anaemia (36.55%), accidental haemorrhage (20.92%), postpartum haemorrhage (8.34%), placenta praevia (5.03%) and caesarean section (10.33%) were the common indications for blood transfusion. In more than 65% cases, two or three unit of blood were transfused. In majority of cases (96%) components were used.Conclusions: Blood transfusion helped to save many lives in the present study. Severe anaemia and obstetric haemorrhage of varied aetiology were the common indications for blood transfusion. Component therapy helped to correct specific deficiency. Voluntary blood donation should be encouraged in the younger generation to keep adequate stock of blood in blood bank for emergency use. Preventive measures like improving dietary iron intake and prophylactic iron therapy will go a long way in reducing the need for blood transfusion in Obstetrics.

Background: Eclampsia is a hypertensive disorder related to pregnancy, in which there is occurrence of one or more generalized convulsions and or coma, in the absence of other neurologic conditions. It is a common obstetric emergency. Eclampsia is associated with elevated maternal and fetal morbidity and mortality. Objectives: To compare the efficacy of low dose magnesium sulphate (Dhaka) regime with Pritchard regime in Eclampsia. Material and Methods: A prospective randomized study of fifty eclampsia cases, treated with magnesium sulphate (25 each from low dose magnesium sulphate (Dhaka) regime and Pritchard regime) was carried out for one year i.e. January 2010 to December 2010 at Pravara Rural Hospital, Loni. Results were analysed using Statistical Package of Social Sciences (SPSS) 13.0. Results: In the present study, convulsions were controlled in 88% of eclampsia cases with low dose magnesium sulphate (Dhaka) regime. Two cases i.e. 8% had single episode of recurrence of convulsion, which was controlled by giving additional 2 grams of 20% magnesium sulphate intravenous single dose. Perinatal mortality in low dose magnesium sulphate (Dhaka) regime was lesser (24%) than Pritchard regime (32%). Conclusion: Low dose magnesium sulphate (Dhaka) regime was equally effective as Pritchard regime in control of eclamptic convulsions. There was no magnesium related toxicity with low dose magnesium sulphate (Dhaka) regime. Maternal and perinatal outcome was better in low dose magnesium sulphate (Dhaka) regime as compared to Pritchard regime.

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