Background: Abnormal uterine bleeding is a common clinical problem with myriad of causes. The diagnosis and management of abnormal menstrual function must be based on an understanding of the physiologic mechanisms involved in the regulation of the normal cycles. Diagnostic hysteroscopy is a valuable tool in diagnosing structural intra-cavital pathology, very suitable for out-patient clinic.Methods: This is a prospective study which has been carried out in the Department of Obstetrics and Gynecology, Tirunelveli medical college hospital, Tirunelveli, Tamil Nadu from January 2011 to October 2011.Results: A total of 50 cases were analysed among the 50 patients tested. 26 patients had some pathology of which 24were accurately detected by hysteroscopy, missed 2 cases of irregular shedding endometrium which was reported by histopathology.Conclusions: Hysteroscopy is a safe, reliable and quick procedure in the diagnosis of cases with abnormal uterine bleeding with high sensitivity, specificity and negative predictive value.

INTRODUCTIONCaesarean section represents the most significant interventional operative procedure in all of obstetrics. Its development and meaningful application has helped us to provide safe motherhood and improved quality of life of mother and new born by avoiding serious delivery complications. The incidence of cesarean section has increased tremendously over the recent years. The rate of cesarean deliveries continues to increase despite efforts to constrain operative abdominal deliveries. This is a cause for concern because cesarean section is associated with higher likelihood of adverse outcomes for both mother and fetus as compared to vaginal delivery. There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity. Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient's majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications. Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.