Induction of labour may be required for various maternal or foetal reasons at times in the presence of poor Bishop's scoring. Cervical ripening is beneficial in these situations. A randomised comparative analysis was carried out using intracervical Foleys catheter instillation followed by a single dose of dinoprostone gel if required in one group and only dinoprostone gel for ripening in other group. Maternal and neonatal complications, mode of delivery and induction-delivery interval were assessed. We found a higher vaginal delivery rate of 82% in the first group in comparison to 64% in the other group. The difference was statistically significant (p=0.0426). Though a longer induction-delivery interval was observed in the first group, the maternal and foetal outcomes were similar. Intracervical Foley's catheter instillation when used for cervical ripening in unfavourable cervices, either alone or sequentially with dinoprostone gel can significantly reduce the Primary Caesarean section rate without compromising maternal and neonatal safety.

Background: An ectopic pregnancy occurs when a fertilized ovum implants at a site outside the uterine cavity. The most common location is within the fallopian tube and the condition can be life threatening due to risks of tubal rupture and hemorrhage. Unless more cases are diagnosed at an early stage, it is difficult to reduce mortality, and provide fertility preserving management. Aim and objective: To determine the local incidence of ectopic gestation, its risk factors, clinical presentations and management provided. Materials and methods: This was a prospective observational study where ectopic pregnancy cases admitted over one year in a tertiary care hospital in eastern India, were analyzed regarding age, parity, risk factors, signs and symptoms, management and morbidity. Results: There were total 280 cases, with incidence of 13.03/1000 deliveries. Most patients were primipara, between 21-30 years. The common risk factors were previous cesarean section (CS) in 26.07% and pelvic inflammatory disease (19.04%). Predominant symptom was abdominal pain (98.21%) and classic triad was present in 45% cases. Adnexal and cervical motion tenderness was elicited in most, while 10% presented in acute shock. Right sided ampullary tubal ectopic was the most common type encountered, with 70% cases in ruptured state. Salpingectomy was the mainstay treatment (85.36%). Successful non-surgical management was given to 7.14% cases. There was no mortality. Conclusion: The majority of cases in this study were received in ruptured condition, rendering conservative management impossible, a drawback in the era of modern diagnostics. With global increase in CS rate, a risk factor, the ectopic incidence may inadvertently rise, which is an alarming concern. Clinical significance: Awareness of the local trends of ectopic pregnancy, its risk factors, and diverse clinical presentation is of paramount importance for providing efficient management.

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Background: Birth weight is an important predictor of an individual’s survival and well-being and the complications of children born with low birth weight (LBW) continue till adulthood. The incidence and risk factors of LBW are not known in the Andaman and Nicobar Islands and research answers can help institute appropriate preventive measures. The aim of the study was to determine the proportion of LBW due to intrauterine growth restriction (IUGR) and preterm birth (PTB) and its association with selected factors.Methods: The prospective study was conducted in Andaman and Nicobar Islands Institute of Medical Sciences amongst pregnant women admitted between January-June 2021. Women<18 years, with gestational age<28 weeks, and belonging to tribal groups were excluded. After delivery, birth-weight was recorded to the nearest 10 g in first hour.Results: The incidence of LBW was 24% with 57% due to IUGR. It was significantly higher in recent immigrants, gravidity beyond three, smokeless tobacco uses during pregnancy, high risk pregnancies including multiple miscarriages and preterm deliveries. Five or more antenatal check-ups and > 6 Kg weight gain during pregnancy were protective. Conclusions: Ensuring adequate antenatal check- ups and weight gain during pregnancy, control of tobacco exposure and quality care for women with recurrent abortions and high risk pregnancy is imperative, particularly targeting recent migrants. Strengthening ongoing family planning programmes to increase spacing, identifying pregnancies at risk of preterm deliveries and improved care of premature newborns should be a priority.

Background: Surgical site infection is one of the most common complications after any operative procedure. Aim: To determine the incidence of postoperative surgical site infection in Obstetrics and Gynaecology and also to identify the common causative organisms and their susceptibility to antimicrobials. Material & Methods: We have analysed data from all the postoperative patients suffering from Surgical Site Infection (SSI), from December 2018 to November 2019 in Andaman and Nicobar Islands Institute of Medical Sciences (ANIIMS). Result: Overall incidence of SSI was 9.17%. Staphylococcus aureus was the most common organism identified (38%), with a high incidence of Methicillin Resistant Staphylococcus Aureus (MRSA) (42.86%), followed by Pseudomonas (23.91%). Overall gram-negative bacteria were responsible for more than half of the cases. All the staphylococcal isolates including MRSA were susceptible to linezolid and regarding antibiotic susceptibility of gram-negative organisms, imipenem and piperacillin-tazobactam were most effective. Conclusion: There is emergence of drug-resistant strains of different bacteria such as Pseudomonas and coagulase-negative Staphylococcus. Injudicious use of antibiotics is one of the reasons for this and, hence, there is need for a proper antibiotic protocol that should be formulated based on local trends and susceptibility of microorganisms.