Objective To Asses and develop an indigenous protocol to optimize labour outcome, as Programmed Labor. Design Open, prospective (Between January 2000 to December 2007), randomized, parallel group, monocentric, comparative matching trial. Settings Labor rooms at Nowrosjee Wadia Maternity, Mumbai. Selection criteria 200 patients in each group, aged between 21-30, as low-risk parturient. Intervention Partography, Oxytocin, Primiprost, Pentazocin, Dizepam, Tramadol, Drotin, Ketamine. Outcome parameters Satisfactory obstetric outcome, progressive labor of shorter duration, less blood loss and pain relief. Results Study group had mean shorter duration of active labor as 3.5 hrs compared to controls of 5.2 hrs. Excellant pain relief was of 24 and 62% of substantial relief in comparison to 32% only in other group with no patient falling in excellent group. Second stage of labor was reduced by half (26 to 48 meters) and lesser third stage blood loss. Conclusions Programmed labor with indigenous protocol developed and practiced, results in progressive, shorter, and comfortable labors with lesser blood loss.

Context Intravaginal placement of misoprostol has been used extensively to terminate second trimester pregnancies. Intracervical misoprostol is an alternative method of termination of pregnancy for women in this period of gestation. Objective To assess the efficacy and safety of combined intracervical and intravaginal misoprostol in the management of mid-trimester medical termination of pregnancy and to compare it with intravaginal misoprostol. Materials and MethodsIn this IRB approved prospective study, twenty-two women (mean age 25.4 ± 3.2 years, range 23-32 years; mean BMI 22.3 ± 3.4 kg/m 2 ; mean parity 2.1 ± 1.4, average gestational age 17.9 ± 2.4 weeks) underwent second trimester termination of pregnancy at our institution. Patient cohort was randomized into two treatment protocols depending on the drug used and route of administration. Induction-abortion interval, need for surgical evacuation, completeness of abortion and side effects if any were documented. Results Mean induction-abortion interval for intravaginal group and combination group was comparable (t = 7.9 ± 1.8 and 6.5 ± 3.5 h, respectively). Three patients required surgical evacuation for incomplete abortion (n = 2 after vaginal misoprostol and one after intracervical-intravaginal misoprostol). Number of patients aborting within 6 h was more in the intracervical-intravaginal group (36.3 %). Patients with intracervical misoprostol complained of abdominal pain more often than

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