Postpartum haemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity especially in the developing countries like India. Uterine compression sutures, originally described by B-Lynch et al can successfully control life-threatening PPH. With this background, we studied the use of modified B-Lynch sutures in our setup.It was a single centre, hospital based cross sectional study conducted in the department of obstetrics and gynaecology in a tertiary care hospital in Maharashtra. About 50 cases during the study period (Nov 2017 to June 2019) who failed the medical management of control of PPH were included in the study. Demographic details like age, gestational age, religion, socio economic status and gravid were noted in the case record form. Amount of blood loss, success rates, immediate complications and follow up fertility were assessed.Among the 50 study subjects, 24% had blood loss of <1000ml, 54% had loss between 1000 to 1500ml, 16% had loss of 1501 to 2000ml and 6% had loss more than 2000ml in the present study. About 80% of the cases were successful and 20% failed in the present study. About 6% of the cases had wound gaping, 12% each had fever and had hospital stay more than 5 days and 14% of the cases had wound infection in the present study. About 90% of the cases had return of regular menstruation in the present study.The success rate of B Lynch suture was 80% in the present study. There were few post operative immediate complications in our study. Follow up data also suggested that majority of them recovered with normal routine. In our experience, the B-Lynch technique is a safe, effective and easily implemented method of arresting bleeding in cases of major primary PPH due to uterine atony.

BACKGROUND- Since ancient times, labour inducton is a well established obstetric concept. In the past few decades, rate of labour induction has increased dramatically. The primary objective of this study was to compare the efcacy of transcervical foley catheter with intracervical dinoprostone gel for cervical ripening and labour induction in term singleton pregnancies with unfavourable cervix. METHODS- Term singleton pregnancies fullling inclusion criteria were randomized by chit box system to receive intracervical dinoprostone or transcervical foley catheter. Progress of labour was monitored with the help of partogram. Labour augmentation was done by oxytocin. RESULTS- 110 patients in each group were enrolled. Group A was induced with transcervical Foley catheter and group B with dinoprostone gel. Baseline characteristics like maternal age, parity, gestational age were comparable in each group. There was a signicant difference in the Bishop's score (<.0.05) at the end of 12 hours, Group B showing a greater improvement than A. A signicant difference was also observed in the requirement of augmentation with Pitocin, 77.27% in foley group and 63.63% in dinoprostone group . Although, there was no signicant difference observed in the mode of delivery (p>0.05) and induction to delivery time interval (p>0.05) , maternal and neonatal morbidity between the groups. CONCLUSION- To conclude, Dinoprostone is associated with rapid cervical ripening . Although, mean induction to delivery interval and number of vaginal deliveries were comparable between the groups. Moreover, cost and safety prole of foley catheter makes it comparable or even superior to dinoprostone gel for cervical ripening and induction of labour, especially in developing countries.

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