Background: Hysterectomy is the most common operation performed by gynecologist, next to caesarean section. Currently, there are three main types of hysterectomy operations in practice for benign diseases-Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and Laparoscopic hysterectomy (LH). Vaginal route for non-descent uterus is an acceptable method of hysterectomy. The objective of present study was to compare the operating time, intraoperative and postoperative complications between VH and TAH in non-descent uterus.Methods: The study was conducted in the Postgraduate department of Gynaecology and Obstetrics for a period of 18 months between April 2013 to October 2014 in the Government Lalla Ded Hospital - an associated hospital of Government Medical College, Srinagar; which is the sole tertiary care referral centre in the valley.Results: Over the study period 100 patients were taken, 50 patients underwent non-descent vaginal hysterectomy and labelled as group A and 50 patients were under went total abdominal hysterectomy and labelled as group B. It was seen that intraoperative complications and postoperative complications were less in group A patients and operating time is also less with group A patients when compared with group B patients.Conclusions: From the present study, it was concluded that NDVH is associated with less blood loss during surgery, quicker recovery, and early mobilization, less operative and less postoperative morbidity when compared to TAH. NDVH is a less invasive technique with shorter hospital stay and faster convalescence.

Background: Amniotic fluid is an important part of pregnancy sac and helps in fetal development. There is a consistent association between low AFI and conditions like pregnancy induced hypertension, postdated pregnancy and IUGR resulting in poor fetal outcome. In fact, high risk patients with low amniotic fluid index need to deliver quickly. So, an assessment of amniotic fluid volume has become an important component of antenatal testing for the high risk pregnancy. The objective was to study the correlation between Amniotic fluid index less than 5 cm (AFI˂5) and adverse perinatal outcome in high risk pregnancies.Methods: It was a hospital based prospective, comparative study. 150 high risk patients were selected from inpatient department of obstetrics and Gynecology Government Medical College Srinagar, Jammu and Kashmir, India over a period of one and half year. High risk pregnancies belonging to study group with AFI˂5 were demographically matched with high risk pregnancies with AFI >5 serving as comparison group. Perinatal outcome, rate of caesarean section and early intervention need were compared between the two groups.Results: 77.3% women in study group underwent caesarean section as compared to 28% in control group to prevent adverse perinatal outcome. 60% babies in study group had APGAR score less than 6 at 1 minute compared to only 8% in control group. 61.4% babies in study group needed NICU admission compared to 10.7% in study group.Conclusions: AFI is predictor of adverse outcome for high risk pregnancies. The early recognition alerts an obstetrician to prevent perinatal catastrophe if timely intervention is done along with antepartum and intrapartum fetal monitoring.

Background: Uterine leiomyoma (i.e. fibroid or myoma) are benign clonal tumours arising from the muscle cell of the uterus .Uterine myomas are the commonest tumour over the age of 30 years and seen in 2% pregnant women. The impact of uterine myomas on pregnancy depends on the size, number and location of myoma. Myomectomy is a surgery to remove one or more fibroids. Recently, it has been suggested that caesarean myomectomy is a safe surgical modality if is performed in carefully selected patients. The aim of the study was to assess the safety and feasibility of performing myomectomy during caesarean section.Methods: This prospective observational study was conducted in the Postgraduate Department of Gynaecology and Obstetrics for a period of one and a half year in Government Lalla Ded Hospital – an associated hospital of Government Medical College, Srinagar which is the sole tertiary care referral centre in the valley.Results: A total of 54 patients were taken for caesarean myomectomy. Majority of the patients were in the age group of 26-30years and were of para-1 or 2. Mean blood loss was ≤500 ml during surgery. Most common intraoperative complication was haemorrhage and post-operative complication was fever.Conclusions: From the present study, it is concluded that with the advent of better anaesthesia and availability of blood, caesarean myomectomy is no longer a dreaded job in the hands of an experienced surgeon and in a well-equipped tertiary institution.