Background & objectives: Bacterial vaginosis (BV) is a Reproductive tract infection (RTI) among young sexually active women with high prevalence. It is associated with complications related to pregnancy and an increased risk of acquiring STDs. This poses a need for cost-effective detection of BV in low resource settings. Hence, we propose to study the utility of vaginal pH determination for the detection of BV. Material & Methods: This is a single center, 1 year cross-sectional study. Swabs were collected from 250 non-pregnant women attending the out-patient department of Obstetrics and Gynecology with vaginal discharge as a predominant symptom with or without backache and abdominal pain. Vaginal pH determination, Gram stain, wet mount, Whiff test, and Amsel’s criteria were used for BV detection. Results: 250 study participants with vaginal discharge suggestive of BV were analyzed. Vaginal pH was significantly higher in women with BV with the mean pH being 6.2. Vaginal pH >4.5 had a sensitivity of 85% and specificity of 66% to detect BV. The Whiff test had the least sensitivity. Clue cells and Amsel’s criteria of ≥ 3 were significant for BV. A combination of pH and Whiff test performed better had high sensitivity and specificity. Conclusions: A combination of pH determination and the Whiff test serves as a low-cost alternative in resource-poor settings for detection of BV. Though Clue cells and Amsel’s criteria ≥ 3 were most sensitive and specific, they cannot be used in low resource settings. Vaginal pH alone can be used to detect BV in areas of low prevalence.

Background: Iodine is a nutritionally important trace element and its deficiency is a common health problem affecting a huge population, particularly pregnant women and children. The physiological role of iodine in the human body is synthesis of thyroid hormones. Thyroxine is approximately 60% iodine by weight. If iodine intake falls below approximately 100μg/day, Thyroid Stimulating Hormone (TSH) secretion is augmented, which increases plasma inorganic iodide clearance. Aims and Objective: To correlate urinary iodine with serum TSH in the second trimester of pregnant women. Material and Methods: One hundred five subjects were included in the study from tertiary care hospital. A random urine sample was collected. Iodine was estimated by ammonium persulfate method and TSH values were collected from the OBG department of the subjects enrolled. Statistics: Pearson correlation coefficient was done. Results: Median UI 138.50 (29.80-350.51) μg/L, median TSH 1.90(0.17-7.46) mIU/L. There was no significant correlation between UI and serum TSH with r = (0.0873, (p = 0.3756). Conclusion: Urinary iodine is a marker for population iodine status. A preferable biomarker is necessary to know the iodine status of individual which include not only nutritional biomarker and also required to organise reference range for TSH.

Background: Premature rupture of membranes is the Preterm Premature rupture of membranes (PPROM) is the rupture of amniotic membranes before the onset of labour prior to 37 weeks gestation. PPROM complicates 3.5% to 5% of pregnancies. There are several risk factors which precipitate PPROM. The commonest risk factors are vaginal infection, short cervix, urinary tract infections. Some common complications seen in Preterm PROM are delivery within one week, cord compression, respiratory distress syndrome, abruptio placenta. Since all patients with PPROM have to be screened for vaginal infections as initiating antibiotics is an important aspect in the management. This study aims to assess the bacteriology involved in PPROM in this centre. Aim & Objectives: To determine bacteria isolated from PPROM and the antibiotic sensitivity of the isolates. Materials and Methods: This is a Cross-sectional study conducted on 60 pregnant women with PPROM who got admitted in labour room of KLE Dr. Prabhakar Kore Charitable Hospital. PPROM was confirmed by nitrazine paper and sterile speculum examination. Under aseptic conditions high vaginal swabs were collected. Result: In this study 57% of the deliveries were through cesarean section. 30% of deliveries included in this study occurred within 24 hours. Bacteria isolated were Enterococcus faecalis (39%), Escherichia coli (28%), Klebsiella pneumonia (13%), Staphylococcus aureus (11%), Proteusmirabilis (6%), Pseudomonas aeruginosa (4%). Imipenem showed (94%) sensitivity to gram negative bacteria isolated and Linezolid showed sensitivity to (77.7%) of Gram-positive isolates compared to other antibiotics. Conclusion:Vaginal infection is an important risk factor for PPROM and preterm labour. Patient with risk need to be monitored closely and correct treatment need to be given to manage PPROM reducing the chances of morbidity and mortality.

Background- The global burden of premature babies is mostly contributed by preterm births. Preterm premature rupture of membranes (PPROM) account for nearly 40% of all preterm deliveries. Objective-The study was done to evaluate the clinic-bacteriological prole and the obstetric outcome in pregnancies complicated by preterm premature rupture of membranes. Material and methods-This was a prospective cohort study of cases of PPROM admitted in the teaching hospital which is a major referral tertiary care centre. A total of 64 women were enrolled. We studied the patient demographics, bacterial prole and obstetric outcome in these women. Results-Most of the cases of PPROM were seen in low risk primigravidae. Infections were the commonest cause for PPROM. Enterococcus Faecalis was the most commonly isolated organism. The mean latent period was 3-7 days. Most women delivered vaginally. Respiratory distress and low birth weight with Apgar <6 were the common indications for NICU admission. Co-relation between TLC and hs-CRP levels was not statistically signicant across different groups. Conclusion- Effective screening for cervico-vaginal infections in pregnancy and appropriate antibiotic therapy will help reduce infection related feto-maternal morbidity and mortality. Lesser gestational ages are associated with poorer outcome.

Background: Peripartum hysterectomy (PH) is an emergency obstetric procedure performed most commonly for intractable postpartum haemorrhage. Objectives: Our aim was to study the patient demographics, incidence, indications of PH and compare emergency vs elective PH. Patients and methods: This was a retrospective analysis of all cases of PH performed over 5 years at our tertiary care hospital. The association of variables was based on Chi-square test and Fisher's exact test. Mann-Whitney U-test was used to compare the distributions between groups.Results: A total of 53 peripartum hysterectomies were done in a period between January 2016to December 2020. Incidence of PH was 1.71/1000 deliveries. PPH was the commonest indication of PH followed by placenta previa. 12 were planned elective PH. Haemorrhage and bladder injury were commonly encountered intra-op complications. ICU admissions were mainly for management of shock, disseminated intravascular coagulation and renal failure. There were 7 maternal deaths noted. Emergency PH were associated with overall higher mortality and morbidity than elective PH. Conclusion: Multidisciplinary approach involving an experienced obstetrician, anaesthetist, urologist & intensivist is needed for management of patients warranting PH. Haemorrhage continues to be leading indication for Emergency PH with higher risk of mortality. Antenatal anticipation of risk factors and early referral will help reduce maternal mortality.